Prevalence and determinants of thirst distress amongst patients on maintenance haemodialysis

Thirst and xerostomia are the main causes of poor adherence to fluid restriction and of excessive intake of fluids in patients on chronic haemodialysis. Thirst distress, defined as the degree to which a person is bothered by thirst, is hence a cause of high interdialytic weight gain and its consequences (cardiovascular death, deterioration of the quality of life).

A hospital-based cross-sectional study was carried out from 18th Dec 2023 to 11th April 2024, in 4 government-funded haemodialysis centres in three randomly selected regions of Cameroon. Patients received twice-weekly dialysis. Three hundred patients on maintenance haemodialysis for over 3 months were evaluated for thirst distress using the thirst distress scale and its characteristics, using a structured questionnaire before dialysis sessions.

About 184 (61.33%) patients had thirst distress, with 123 (57.7%) patients being "Always" thirsty. More than 90% of patients have never been consulted for thirst distress. Two hundred and twelve (70.6%) patients felt that their thirst was well managed, and 194 (64.7%) of patients felt that their thirst had no negative impact on how comfortable their lives were. Strategies used by patients to avoid thirst included staying out of the hot sun 256 (85.3%), drinking cold or iced water 222 (73.9%), taking medications with meal fluids 222 (73.9%) and limiting salt in food 192 (64.2%). The xerostomia severity score was significantly associated with thirst distress (p < 0.001, OR = 1.93). For every patient who perceived their thirst was adequately managed, there was a significant 3.89-fold decrease in their TDS score (p < 0.001, OR = 3.896). Thirst distress negatively impacted the quality of life of the patients (OR: 0.76, p = 0.021).

61% of patients on maintenance haemodialysis had thirst distress, and most patients had never been consulted for thirst distress. The determinants of thirst distress included: xerostomia, being thirsty frequently, how well their thirst was and if the patient felt it had a negative impact on how comfortable their lives were.

Not applicable.