Patient-reported symptoms during dialysis: the effect of pre-dialysis extracellular water and change in extracellular water post-dialysis
Abstract Background Quality of life for haemodialysis (HD) patients may be affected by symptoms during dialysis treatments, and patient groups have highlighted the need to improve post-dialysis fatigue and dialysis-related symptoms. As changes in extracellular water (ECW) may lead to cramps and othe...
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doaj-90e088c7260d40f1abe96d4c947cc8232021-01-31T16:38:49ZengBMCRenal Replacement Therapy2059-13812021-01-01711910.1186/s41100-021-00321-3Patient-reported symptoms during dialysis: the effect of pre-dialysis extracellular water and change in extracellular water post-dialysisSuree Yoowannakul0Surachet Vongsanim1Kamonwan Tangvoraphonkchai2Ahmed Mohamed3Andrew Davenport4Division of Nephrology, Department of Medicine, Bhumibol Adulyadej HospitalRenal Division, Department of Internal Medicine, Chiang Mai UniversityFaculty of Medicine, Mahasarakham UniversityUCL Department of Nephrology, Royal Free HospitalUCL Department of Nephrology, Royal Free HospitalAbstract Background Quality of life for haemodialysis (HD) patients may be affected by symptoms during dialysis treatments, and patient groups have highlighted the need to improve post-dialysis fatigue and dialysis-related symptoms. As changes in extracellular water (ECW) may lead to cramps and other symptoms, we wished to determine whether there was an association between ECW and intra-dialytic symptoms. Methods We reviewed the hospital records of HD patients who completed a self-reported intra-dialytic symptom questionnaire, using a visual analogue scale, who had contemporaneous pre- and postdialysis bioimpedance ECW measurements adjusted to height (aECW). Results We studied dialysis sessions of 506 patients, 314 (62.1%) male, 226 (44.7%) diabetic, mean age 64.6 ± 15.7 years, weight 69.9 ± 17.4 kg, and duration of dialysis treatment 26 (9.6–60.1) months. We divided patients into three groups according to pre-dialysis aECW, and total dialysis symptom scores were greater for those in the lower tertile (25 (10–41) vs middle 18 (8.5–34) vs upper 20 (7–31), p < 0.05). Only feeling cold, dizziness, and low blood pressure were statistically different between the three pre-dialysis aECW groups, and there was no difference in post-dialysis recovery times. We analysed the effect of the fall in aECW pre-to post-dialysis. Patients in the group with the greatest fall in aECW did not report more intra-dialytic symptoms or longer recovery times. Conclusion We found that patients starting dialysis with lower relative ECW were more likely to report intra-dialytic symptoms than those with greater amounts of fluid to remove, and most commonly reported symptoms were associated with intra-vascular volume depletion.https://doi.org/10.1186/s41100-021-00321-3HaemodialysisDistress thermometerExtracellular waterCrampsHeadaches |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Suree Yoowannakul Surachet Vongsanim Kamonwan Tangvoraphonkchai Ahmed Mohamed Andrew Davenport |
spellingShingle |
Suree Yoowannakul Surachet Vongsanim Kamonwan Tangvoraphonkchai Ahmed Mohamed Andrew Davenport Patient-reported symptoms during dialysis: the effect of pre-dialysis extracellular water and change in extracellular water post-dialysis Renal Replacement Therapy Haemodialysis Distress thermometer Extracellular water Cramps Headaches |
author_facet |
Suree Yoowannakul Surachet Vongsanim Kamonwan Tangvoraphonkchai Ahmed Mohamed Andrew Davenport |
author_sort |
Suree Yoowannakul |
title |
Patient-reported symptoms during dialysis: the effect of pre-dialysis extracellular water and change in extracellular water post-dialysis |
title_short |
Patient-reported symptoms during dialysis: the effect of pre-dialysis extracellular water and change in extracellular water post-dialysis |
title_full |
Patient-reported symptoms during dialysis: the effect of pre-dialysis extracellular water and change in extracellular water post-dialysis |
title_fullStr |
Patient-reported symptoms during dialysis: the effect of pre-dialysis extracellular water and change in extracellular water post-dialysis |
title_full_unstemmed |
Patient-reported symptoms during dialysis: the effect of pre-dialysis extracellular water and change in extracellular water post-dialysis |
title_sort |
patient-reported symptoms during dialysis: the effect of pre-dialysis extracellular water and change in extracellular water post-dialysis |
publisher |
BMC |
series |
Renal Replacement Therapy |
issn |
2059-1381 |
publishDate |
2021-01-01 |
description |
Abstract Background Quality of life for haemodialysis (HD) patients may be affected by symptoms during dialysis treatments, and patient groups have highlighted the need to improve post-dialysis fatigue and dialysis-related symptoms. As changes in extracellular water (ECW) may lead to cramps and other symptoms, we wished to determine whether there was an association between ECW and intra-dialytic symptoms. Methods We reviewed the hospital records of HD patients who completed a self-reported intra-dialytic symptom questionnaire, using a visual analogue scale, who had contemporaneous pre- and postdialysis bioimpedance ECW measurements adjusted to height (aECW). Results We studied dialysis sessions of 506 patients, 314 (62.1%) male, 226 (44.7%) diabetic, mean age 64.6 ± 15.7 years, weight 69.9 ± 17.4 kg, and duration of dialysis treatment 26 (9.6–60.1) months. We divided patients into three groups according to pre-dialysis aECW, and total dialysis symptom scores were greater for those in the lower tertile (25 (10–41) vs middle 18 (8.5–34) vs upper 20 (7–31), p < 0.05). Only feeling cold, dizziness, and low blood pressure were statistically different between the three pre-dialysis aECW groups, and there was no difference in post-dialysis recovery times. We analysed the effect of the fall in aECW pre-to post-dialysis. Patients in the group with the greatest fall in aECW did not report more intra-dialytic symptoms or longer recovery times. Conclusion We found that patients starting dialysis with lower relative ECW were more likely to report intra-dialytic symptoms than those with greater amounts of fluid to remove, and most commonly reported symptoms were associated with intra-vascular volume depletion. |
topic |
Haemodialysis Distress thermometer Extracellular water Cramps Headaches |
url |
https://doi.org/10.1186/s41100-021-00321-3 |
work_keys_str_mv |
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