Thirst Distress Common and Overlooked in Hemodialysis Patients: Study Suggests
Cameroon: A study found 61% of maintenance hemodialysis patients experienced thirst distress, often without prior consultation. Key determinants included xerostomia, frequent thirst, thirst severity, and perceived negative impact on life comfort. The findings, published in BMC Nephrology, highlight an under-recognized challenge in dialysis care.
The research, led by Denis Georges Teuwafeu from the Faculty of Health Sciences at the University of Buea, Cameroon, explored the prevalence and factors linked to thirst distress in individuals undergoing long-term hemodialysis. Thirst distress, defined as how bothersome a person finds their thirst, is a major contributor to excessive fluid intake and high interdialytic weight gain, both of which can lead to cardiovascular complications and reduced quality of life.
The cross-sectional study was conducted between December 18, 2023, and April 11, 2024, across four government-funded dialysis centers in three randomly selected regions of Cameroon. A total of 300 patients, each on maintenance hemodialysis for more than three months and receiving twice-weekly sessions, were assessed. Data were collected before dialysis using the Thirst Distress Scale and a structured questionnaire to capture thirst characteristics, management strategies, and perceived impact.
The following were the key findings of the study:
- 61.33% of maintenance hemodialysis patients experienced thirst distress.
- 57.7% of those with thirst distress reported being “always” thirsty.
- Over 90% had never discussed their thirst distress with a healthcare professional.
- 70.6% felt their thirst was adequately managed.
- 64.7% believed thirst had no significant impact on their comfort.
- Common strategies to reduce thirst included avoiding hot sun (85.3%), drinking cold or iced water (73.9%), taking medications with mealtime fluids (73.9%), and limiting salt intake (64.2%).
- Xerostomia severity was significantly associated with thirst distress (OR = 1.93).
- Feeling thirst was well managed and was linked to a 3.89-fold lower Thirst Distress Scale score.
- Thirst distress negatively affected quality of life (OR: 0.76).
- Twice-weekly dialysis sessions may contribute to higher rates of thirst distress.
The authors noted that the high prevalence of thirst distress could be partly explained by the twice-weekly dialysis schedule, which may contribute to greater fluid accumulation between sessions. They also acknowledged study limitations, including not assessing biochemical factors that may influence thirst, not using the more comprehensive Xerostomia Thirst Inventory, and potential recall bias in patient responses. Furthermore, the absence of cut-off values and reference categories in regression analysis could affect the interpretation of determinants.
The researchers emphasize that thirst distress remains largely underdiagnosed and undertreated in dialysis patients, despite its potential impact on adherence to fluid restrictions and overall well-being. They advocate for greater clinical attention, routine assessment, and targeted interventions to manage thirst effectively, which could improve both treatment compliance and patient quality of life.
Reference:
Teuwafeu, D.G., Fonyuy, V.F., Bandolo, N.V. et al. Prevalence and determinants of thirst distress amongst patients on maintenance haemodialysis. BMC Nephrol 26, 441 (2025). https://doi.org/10.1186/s12882-025-04369-9
