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Kidney Week

Abstract: SA-OR069

Thirst, Xerostomia, and Inter-Dialytic Weight Gain in the Sodium Lowering in Dialysate (SoLID) Trail

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Luey, Brenda M., Middlemore Clinical Trials, Auckland, New Zealand
  • Dunlop, Joanna Leigh, Middlemore Hospital, Auckland, New Zealand
  • Marshall, Mark R., Middlemore Hospital, Auckland, New Zealand

Group or Team Name

  • for the SoLID trial investigators
Background

A number of observational studies and clinical trials have shown that lower dialysate [Na+] is associated with reduced fluid intake in hemodialysis (HD) patients. We report the effect of lower dialysate [Na+] on thirst, xerostomia, and inter-dialytic weight gain (IDWG) in the Sodium Lowering in Dialysate (SoLID) trial (ACTRN12611000975998, www.solid.org.nz).

Methods

The SoLID trial randomised 99 participants on home or self-care HD from 11 sites in New Zealand to the control group (dialysate [Na+] of 140mM) or intervention group (135mM) for 12 months. Thirst and xerostomia were scored by validated inventories - the Dialysis Thirst Inventory or DTI (Bots 2004), and the Xerostomia Inventory or XI (Thomson 2011). IDWG was measured as the weight gain between dialysis sessions averaged over a two-week period. Outcomes were ascertained at baseline, 6 and 12 months, and analysed using generalized linear models on an intention-to-treat basis.

Results

Results are tabulated in Table 1. IDWG was lower in the intervention group compared to the control group at all time-points There was little or no difference in thirst and xerostomia between the control and intervention groups at either 6 or 12 months.

Conclusion

In the SoLID trial, lower dialysate [Na+] clearly reduced fluid intake, consistent with previous clinical trials. The intervention did not change DTI and XI, however, despite previous observational studies showing positive correlation between DTI and XI with IDWG (Bots 2004). Further research is underway to determine the relationship between IDWG and the individual items within the DTI and XI instruments. It may be that the DTI and XI are invalid in prospective settings due to recall bias or other reasons, and that other methods are more suitable for determining the longitudinal effects of different interventions on thirst and xerostomia.

Mean difference (p-value) in outcomes between control and intervention group at 6 and 12 months
 Dialysis Thirst Inventory (DTI) scoreXerostomia Inventory (XI) scoreIDWG in kg
6 months-1.22 (0.38)-0.62 (0.53)-0.559 (0.001)
12 months0.57 (0.68)0.38 (0.70)-0.569 (<0.0005)

Funding

  • Commercial Support