Abstract: PO1078
Coffee and Headache in Hemodialysis Patients: The CoffeeHD Trial
Session Information
- Hemodialysis and Frequent Dialysis - 1
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Aoun, Mabel, Saint-Joseph University, Beirut, Lebanon
- Hilal, Najla, Universite Saint-Esprit de Kaslik, Jounieh, Lebanon
- Beaini, Chadia H., Bellevue Medical Center, Mansourieh, Mount Lebanon, Lebanon
- Sleilaty, Ghassan, Saint-Joseph University, Beirut, Lebanon
- Hajal, Joseph, Saint-Joseph University, Beirut, Lebanon
- El boueri, Celine, Saint-George Hospital, Ajaltoun, Lebanon
- Chelala, Dania, Saint-Joseph University, Beirut, Lebanon
Background
Headache occurs in 40 to 75 % of HD patients. Caffeine circulates unbound in the blood and passes the dialysis membrane. Some suggested that headache can result from caffeine withdrawal. This study aims to compare the incidence of headache and hypotension between patients taking or not coffee during dialysis.
Methods
This is a randomized double-blind multicenter trial. Patients of 3 HD units were included. 156 patients were randomized to two groups, group A was given coffee and group B decaffeinated coffee mid-session for 12 sessions. UF rate was fixed to <13 ml/kg/h. Primary outcome was incidence of headache and secondary outcome incidence of hypotension. This clinical trial received the approval of the ethics committee and was registered on ClinicalTrials.Gov (NCT04057313).
Results
139 patients completed the trial (6.4% vs 15.4 % of withdrawal in A and B respectively). Baseline characteristics are summarized in Table 1. Incidence of headache was not significantly different between A and B (34% vs 37% respectively, p=0.522), nor the incidence of hypotension (27% vs 26% respectively, p= 0.539). In subgroup analysis, headache was lower in A (p=0.06) in two categories of patients: those with higher potassium dialysate (K=2) and the non-hypertensive patients.
Conclusion
Headache occurred in 34 to 37% of dialysis sessions. There was no difference in headache or hypotensive episodes between patients in the coffee versus decaffeinated group.
Baseline characteristics
| A | B | p | |
| Age | 64.3±13 | 69±11.4 | 0.016 |
| Sex (M/F) | 71.8%/28.2% | 59%/41% | 0.092 |
| Dialysis Vintage (M) | 39[17-84] | 27[14-55] | 0.086 |
| Smoking (N/Y) | 65.4%/34.6% | 76.9%/23.1% | 0.112 |
| Hypertension (N/Y) | 9%/91% | 15.4%/84.6% | 0.221 |
| Coffee cups daily | 2.4±1.4 | 2.3±1.5 | 0.783 |
| Coffee intake before session (N/Y) | 46.2%/53.8% | 47.4%/52.6% | 0.873 |
| Diabetes (N/Y) | 57.7%/42.3% | 46.2%/53.8% | 0.149 |
| Headache usually (N/Y) | 82.1%/17.9% | 85.9%/14.1% | 0.513 |
| URR | 75.6±5.3 | 76.5±4.9 | 0.274 |
| Dialysate K (0/1/2) | 5.1%/42.3%/52.6% | 7.7%/33.3%/59% | 0.468 |
| Pre HD systolic BP | 146.5±21.7 | 140.4±21.1 | 0.076 |
| Pre HD diastolic BP | 76.7±12.8 | 72.6±11.9 | 0.036 |
| Pre HD heart rate | 71.6±10 | 68.8±10 | 0.077 |
N, No; Y, Yes