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Vol. 33, No. 4, 2010
Issue release date: August 2010
Section title: Original Paper
Kidney Blood Press Res 2010;33:260–265
(DOI:10.1159/000317933)

Effect of Acupressure on Thirst in Hemodialysis Patients

Yang L.-Y.a, b · Yates P.d · Chin C.-C.a · Kao T.-K.c
aSchool of Nursing, bCollege of Nursing, Kaohsiung Medical University, Kaohsiung, cDepartment of Nursing, Tajen University, Pingtung, Taiwan, ROC; dSchool of Nursing and Midwifery, Queensland University of Technology, Brisbane, Qld., Australia
email Corresponding Author

Abstract

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


  

Key Words

  • Thirst
  • Salivary flow rate
  • Acupressure
  • Hemodialysis

References

  1. Giovannetti S, Barsotti G, Cupisti A, et al: Dipsogenic factors operating in chronic uremics on maintenance hemodialysis. Nephron1994;66:413–420.
  2. 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.
  3. 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.
  4. 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.
  5. Flanigan M: Dialysate composition and hemodialysis hypertension. Semin Dial 2004;17:279–283.
  6. 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.
  7. 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.
  8. Mallick NP, Gokal R: Haemodialysis. Lancet 1999;353:737–742.
  9. 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.
  10. Lee SH, Molassiotis A: Dietary and fluid compliance in Chinese hemodialysis patients. Int J Nurs Stud 2002;39:695–704.
  11. Lee Y, Wang R: Helplessness, social support and self-care behaviors among long-term hemodialysis patients. J Nurs Res2001;9:147–158.
  12. Pang SK, Ip WY, Chang AM: Psychosocial correlates of fluid compliance among Chinese haemodialysis patients. J Adv Nurs2001;35:691–698.
  13. 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.
  14. 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.
  15. 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.
  16. 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.
  17. 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.
  18. Johnstone PA, Niemtzow RC, Riffenburgh RH: Acupuncture for xerostomia: clinical update. Cancer 2002;94:1151–1156.
  19. 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.
  20. Lin WJ, Wu MC: Advancements in research of channel and network vessels (in Chinese). J Chin Clin Tradit Med 2004;10:338–344.
  21. 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.
  22. Maa S: Application of acupressure in nursing practice (in Chinese). J Nurs 2005;52:5–10.
  23. Matsumura WM: Use of acupressure techniques and concepts for nonsurgical management of TMJ disorders. J Gen Orthod 1993;4:5–16.
  24. 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.
  25. 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.
  26. 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.
  27. Bayraktar G, Kazancioglu R, Bozfakioglu S, et al: Stimulated salivary flow rate in chronic hemodialysis patients. Nephron 2002;91:210–214.
  28. Dawes C: How much saliva is enough for avoidance of xerostomia? Caries Res 2004;38:236–240.
  29. Yao T: Acupuncture and somatic nerve stimulation: mechanism underlying effects on cardiovascular and renal activities. Scand J Rehabil Med Suppl 1993;29:7–18.

  

Author Contacts

Chi-Chun Chin
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 chichun@kmu.edu.rw

  

Article Information

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

  

Publication Details

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


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References

  1. Giovannetti S, Barsotti G, Cupisti A, et al: Dipsogenic factors operating in chronic uremics on maintenance hemodialysis. Nephron1994;66:413–420.
  2. 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.
  3. 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.
  4. 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.
  5. Flanigan M: Dialysate composition and hemodialysis hypertension. Semin Dial 2004;17:279–283.
  6. 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.
  7. 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.
  8. Mallick NP, Gokal R: Haemodialysis. Lancet 1999;353:737–742.
  9. 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.
  10. Lee SH, Molassiotis A: Dietary and fluid compliance in Chinese hemodialysis patients. Int J Nurs Stud 2002;39:695–704.
  11. Lee Y, Wang R: Helplessness, social support and self-care behaviors among long-term hemodialysis patients. J Nurs Res2001;9:147–158.
  12. Pang SK, Ip WY, Chang AM: Psychosocial correlates of fluid compliance among Chinese haemodialysis patients. J Adv Nurs2001;35:691–698.
  13. 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.
  14. 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.
  15. 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.
  16. 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.
  17. 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.
  18. Johnstone PA, Niemtzow RC, Riffenburgh RH: Acupuncture for xerostomia: clinical update. Cancer 2002;94:1151–1156.
  19. 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.
  20. Lin WJ, Wu MC: Advancements in research of channel and network vessels (in Chinese). J Chin Clin Tradit Med 2004;10:338–344.
  21. 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.
  22. Maa S: Application of acupressure in nursing practice (in Chinese). J Nurs 2005;52:5–10.
  23. Matsumura WM: Use of acupressure techniques and concepts for nonsurgical management of TMJ disorders. J Gen Orthod 1993;4:5–16.
  24. 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.
  25. 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.
  26. 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.
  27. Bayraktar G, Kazancioglu R, Bozfakioglu S, et al: Stimulated salivary flow rate in chronic hemodialysis patients. Nephron 2002;91:210–214.
  28. Dawes C: How much saliva is enough for avoidance of xerostomia? Caries Res 2004;38:236–240.
  29. Yao T: Acupuncture and somatic nerve stimulation: mechanism underlying effects on cardiovascular and renal activities. Scand J Rehabil Med Suppl 1993;29:7–18.