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Kidney Week

Abstract: PO1078

Coffee and Headache in Hemodialysis Patients: The CoffeeHD Trial

Session Information

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
 ABp
Age64.3±1369±11.40.016
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 daily2.4±1.42.3±1.50.783
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
URR75.6±5.376.5±4.90.274
Dialysate K (0/1/2)5.1%/42.3%/52.6%7.7%/33.3%/59%0.468
Pre HD systolic BP146.5±21.7140.4±21.10.076
Pre HD diastolic BP76.7±12.872.6±11.90.036
Pre HD heart rate71.6±1068.8±100.077

N, No; Y, Yes