Background: Thirst and dry mouth are common among hemodialysis (HD) patients. This paper reports a study to evaluate the impact of an acupressure program on HD patients’ thirst and salivary flow rates. Methods: The acupressure program included placebo, followed by true acupressure each applied for 4 weeks. Twenty-eight patients (mean age 57.6, SD = 16.13 years) first received a sticker as placebo acupressure at two acupoints CV23 and TE17 three times a week for 4 weeks, and then received true acupressure in the same area for the next 4 weeks. Salivary flow rate and thirst intensity were measured at baseline, during and after treatment completion for both the placebo and true acupressure program. Results: The true acupressure program was associated with significantly increased salivary flow rate (0.09 ± 0.08 ml/min at baseline to 0.12 ± 0.08 ml/min after treatments completion, p = 0.04). The mean thirst intensity also improved from 4.21 ± 2.66 at baseline to 2.43 ± 2.32 (p = 0.008) after treatment completion in HD patients. There was no statistically significant difference in pre-post program salivary flow rate; however, significant improvement in thirst intensity scores was observed (p = 0.009) in the placebo acupressure program. Conclusion: This study provides preliminary evidence that acupressure may be effective in improving salivary flow rates and thirst intensity.
© 2010 S. Karger AG, Basel
- Salivary flow rate
- Giovannetti S, Barsotti G, Cupisti A, et al: Dipsogenic factors operating in chronic uremics on maintenance hemodialysis. Nephron1994;66:413–420.
- Kho HS, Lee SW, Chung SC, Kim YK: Oral manifestations and salivary flow rate, pH, and buffer capacity in patients with end-stage renal disease undergoing hemodialysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:316–319.
- Sung JM, Kuo SC, Guo HR, et al: Decreased salivary flow rate as a dipsogenic factor in hemodialysis patients: evidence from an observational study and a pilocarpine clinical trial. J Am Soc Nephrol 2005;16:3418–3429.
- Bots CP, Brand HS, Veerman EC, et al: Interdialytic weight gain in patients on hemodialysis is associated with dry mouth and thirst. Kidney Int 2004;66:1662–1668.
- Flanigan M: Dialysate composition and hemodialysis hypertension. Semin Dial 2004;17:279–283.
- Kugler C, Vlaminck H, Haverich A, Maes B: Nonadherence with diet and fluid restrictions among adults having hemodialysis. J Nurs Scholarsh 2005;37:25–29.
- Kalantar-Zadeh K, Regidor DL, Kovesdy CP, et al: Fluid retention is associated with cardiovascular mortality in patients undergoing long-term hemodialysis. Circulation 2009;119:671–679.
- Mallick NP, Gokal R: Haemodialysis. Lancet 1999;353:737–742.
- Durose CL, Holdsworth M, Watson V, et al: Knowledge of dietary restrictions and the medical consequences of noncompliance by patients on hemodialysis are not predictive of dietary compliance. J Am Diet Assoc 2004;104:35–41.
- Lee SH, Molassiotis A: Dietary and fluid compliance in Chinese hemodialysis patients. Int J Nurs Stud 2002;39:695–704.
- Lee Y, Wang R: Helplessness, social support and self-care behaviors among long-term hemodialysis patients. J Nurs Res2001;9:147–158.
- Pang SK, Ip WY, Chang AM: Psychosocial correlates of fluid compliance among Chinese haemodialysis patients. J Adv Nurs2001;35:691–698.
- Kao CH, Hsieh JF, Tsai SC, Ho YJ, Chang HR: Decreased salivary function in patients with end-stage renal disease requiring hemodialysis. Am J Kidney Dis2000;36:1110–1114.
- Kaya M, Cermik TF, Ustun F, Sen S, Berkarda S: Salivary function in patients with chronic renal failure undergoing hemodialysis. Ann Nucl Med2002;16:117–120.
- Blom M, Dawidson I, Angmar-Mansson B: The effect of acupuncture on salivary flow rates in patients with xerostomia. Oral Surg Oral Med Oral Pathol 1992;73:293–298.
- Blom M, Dawidson I, Fernberg JO, Johnson G, Angmar-Mansson B: Acupuncture treatment of patients with radiation-induced xerostomia. Eur J Cancer B Oral Oncol 1996;32B:182–190.
- List T, Lundeberg T, Lundstrom I, Lindstrom F, Ravald N: The effect of acupuncture in the treatment of patients with primary Sjogren’s syndrome. A controlled study. Acta Odontol Scand 1998;56:95–99.
- Johnstone PA, Niemtzow RC, Riffenburgh RH: Acupuncture for xerostomia: clinical update. Cancer 2002;94:1151–1156.
- Johnstone PA, Peng YP, May BC, et al: Acupuncture for pilocarpine-resistant xerostomia following radiotherapy for head and neck malignancies. Int J Radiat Oncol Biol Phys 2001;50:353–357.
- Lin WJ, Wu MC: Advancements in research of channel and network vessels (in Chinese). J Chin Clin Tradit Med 2004;10:338–344.
- Ma H, Chang M, Lin C: A systematic review of acupressure for the application on nursing practice (in Chinese). J Nurs 2007;54:35–44.
- Maa S: Application of acupressure in nursing practice (in Chinese). J Nurs 2005;52:5–10.
- Matsumura WM: Use of acupressure techniques and concepts for nonsurgical management of TMJ disorders. J Gen Orthod 1993;4:5–16.
- Brennan MT, Shariff G, Lockhart PB, Fox PC: Treatment of xerostomia: a systematic review of therapeutic trials. Dent Clin North Am 2002;46:847–856.
- Blom M, Lundeberg T: Long-term follow-up of patients treated with acupuncture for xerostomia and the influence of additional treatment. Oral Dis 2000;6:15–24.
- Bots CP, Brand HS, Veerman EC, et al: The management of xerostomia in patients on haemodialysis: comparison of artificial saliva and chewing gum. Palliat Med 2005;19:202–207.
- Bayraktar G, Kazancioglu R, Bozfakioglu S, et al: Stimulated salivary flow rate in chronic hemodialysis patients. Nephron 2002;91:210–214.
- Dawes C: How much saliva is enough for avoidance of xerostomia? Caries Res 2004;38:236–240.
- Yao T: Acupuncture and somatic nerve stimulation: mechanism underlying effects on cardiovascular and renal activities. Scand J Rehabil Med Suppl 1993;29:7–18.
School of Nursing, Kaohsiung Medical University, No. 100
Shih-Chuan 1st Rd, San Ming District
807 Kaohsiung, Taiwan (ROC )
Tel. +886 7 312 1101, ext. 2605, Fax +886 7 321 8364, E-Mail firstname.lastname@example.org
Received: January 11, 2010
Accepted: April 23, 2010
Published online: July 2, 2010
Number of Print Pages : 6
Number of Figures : 0, Number of Tables : 2, Number of References : 29
Kidney and Blood Pressure Research
Vol. 33, No. 4, Year 2010 (Cover Date: August 2010)
Journal Editor: Tesar V. (Prague)
ISSN: 1420-4096 (Print), eISSN: 1423-0143 (Online)
For additional information: http://www.karger.com/KBR
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.