Thirst, interdialytic weight gain, and thirst-interventions in hemodialysis patients: a literature review

A literature search completed over the period of 1980-1999 identified studies on the prevalence of thirst in hemodialysis (HD) patients and the relationship between thirst and interdialytic weight gain, as well as intervention studies in which thirst was used as an outcome variable. Twenty-three studies fulfilled the selection criteria and were included in the analysis. The prevalence of thirst varied between 6% and 95% across studies. In most studies more thirst was related to more weight gain. However, the studies were difficult to compare due to methodological differences. Three types of interventions were found: technical interventions in the dialysis mechanisms (increasing the frequency of dialysis sessions and varying the concentration of sodium in the dialysate), pharmaceutical interventions (ACE-inhibitors), and a dietetic intervention. Almost no conclusions could be drawn with regard to the effectiveness of these interventions due to methodological differences and weaknesses and due to the small sample sizes.