Thirst in stable heart failure patients; time to reconsider fluid restriction and prescribed diuretics
Abstract Aims One of the bothersome symptoms that heart failure (HF) patients can experience is thirst. There are limited data on the association between thirst and fluid intake and clinical variables. Therefore, the aim of this study was to describe severe thirst in stable HF patients and assess fa...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-08-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.13960 |
| _version_ | 1818473893109694464 |
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| author | Martje H.L. van derWal Tiny Jaarsma Lieset C. Jenneboer Gerard C.M. Linssen |
| author_facet | Martje H.L. van derWal Tiny Jaarsma Lieset C. Jenneboer Gerard C.M. Linssen |
| author_sort | Martje H.L. van derWal |
| collection | DOAJ |
| description | Abstract Aims One of the bothersome symptoms that heart failure (HF) patients can experience is thirst. There are limited data on the association between thirst and fluid intake and clinical variables. Therefore, the aim of this study was to describe severe thirst in stable HF patients and assess factors related to severe thirst, including actual fluid intake and sodium intake. Methods and results The study had a cross‐sectional design. Stable HF patients from two HF clinics in the Netherlands were included and assessed thirst by a visual analogue scale ranging from 0 to 100. They also completed questionnaires on thirst distress, self‐care behaviour, and HF symptoms. A 3 day food diary was completed to assess actual fluid intake and sodium intake. Finally, patients collected urine for 24 h. Patients were divided into severe and low thirst based on thirst score and thirst distress. T‐tests, Mann–Whitney tests, and χ2 tests were conducted to assess differences between both groups. Multivariable logistic regression analysis was performed to assess factors associated with severe thirst. A total of 100 patients were included (40% female, mean age 72 ± 12) of which 68 completed the food diary. The mean thirst score was 28 ± 25, and 25% experienced severe thirst. The majority of patients (94%) were prescribed a fluid restriction, 37% had a restriction between 1500 and 2000 mL, and 32% a restriction of 1500 mL. Severe thirst in the total group with 100 patients was associated with a higher dose of loop diuretics [odds ratio (OR) 3.25; 95% confidence interval (CI) 1.01–10.45; P = 0.048] and a higher urine output over 24 h (OR 1.002; 95% CI 1.00–1.003; P = 0.010). In the group of patients who completed the food diary (N = 68), severe thirst was associated with a higher sodium intake (OR 1.002; 95% CI 1.001–1.003; P = 0.003), a higher dose of loop diuretics (OR 22.69; 95% CI 2.78–185.04; P = 0.004), and more fatigue (OR 11.2; 95% CI 1.54–82.12; P = 0.017). Conclusions A quarter of all stable HF patients experienced severe thirst. A higher dose of loop diuretics was associated with more thirst; therefore, it might be important to review the dose of loop diuretics critically and try to decrease it in order to relieve severe thirst. Because all patients were prescribed a fluid restriction, a reconsideration of this restriction is also suggested. |
| first_indexed | 2024-04-14T04:29:58Z |
| format | Article |
| id | doaj.art-ce5ff876b9f4499b95e6008cde437e3c |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-04-14T04:29:58Z |
| publishDate | 2022-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-ce5ff876b9f4499b95e6008cde437e3c2022-12-22T02:12:08ZengWileyESC Heart Failure2055-58222022-08-01942181218810.1002/ehf2.13960Thirst in stable heart failure patients; time to reconsider fluid restriction and prescribed diureticsMartje H.L. van derWal0Tiny Jaarsma1Lieset C. Jenneboer2Gerard C.M. Linssen3Department of Health, Medicine and Caring Sciences Linkoping University Linkoping SwedenDepartment of Health, Medicine and Caring Sciences Linkoping University Linkoping SwedenBureau HHM Enschede The NetherlandsDepartment of Cardiology Hospital Group Twente (Almelo and Hengelo) Almelo The NetherlandsAbstract Aims One of the bothersome symptoms that heart failure (HF) patients can experience is thirst. There are limited data on the association between thirst and fluid intake and clinical variables. Therefore, the aim of this study was to describe severe thirst in stable HF patients and assess factors related to severe thirst, including actual fluid intake and sodium intake. Methods and results The study had a cross‐sectional design. Stable HF patients from two HF clinics in the Netherlands were included and assessed thirst by a visual analogue scale ranging from 0 to 100. They also completed questionnaires on thirst distress, self‐care behaviour, and HF symptoms. A 3 day food diary was completed to assess actual fluid intake and sodium intake. Finally, patients collected urine for 24 h. Patients were divided into severe and low thirst based on thirst score and thirst distress. T‐tests, Mann–Whitney tests, and χ2 tests were conducted to assess differences between both groups. Multivariable logistic regression analysis was performed to assess factors associated with severe thirst. A total of 100 patients were included (40% female, mean age 72 ± 12) of which 68 completed the food diary. The mean thirst score was 28 ± 25, and 25% experienced severe thirst. The majority of patients (94%) were prescribed a fluid restriction, 37% had a restriction between 1500 and 2000 mL, and 32% a restriction of 1500 mL. Severe thirst in the total group with 100 patients was associated with a higher dose of loop diuretics [odds ratio (OR) 3.25; 95% confidence interval (CI) 1.01–10.45; P = 0.048] and a higher urine output over 24 h (OR 1.002; 95% CI 1.00–1.003; P = 0.010). In the group of patients who completed the food diary (N = 68), severe thirst was associated with a higher sodium intake (OR 1.002; 95% CI 1.001–1.003; P = 0.003), a higher dose of loop diuretics (OR 22.69; 95% CI 2.78–185.04; P = 0.004), and more fatigue (OR 11.2; 95% CI 1.54–82.12; P = 0.017). Conclusions A quarter of all stable HF patients experienced severe thirst. A higher dose of loop diuretics was associated with more thirst; therefore, it might be important to review the dose of loop diuretics critically and try to decrease it in order to relieve severe thirst. Because all patients were prescribed a fluid restriction, a reconsideration of this restriction is also suggested.https://doi.org/10.1002/ehf2.13960ThirstHeart failureFluid restrictionSodium intake |
| spellingShingle | Martje H.L. van derWal Tiny Jaarsma Lieset C. Jenneboer Gerard C.M. Linssen Thirst in stable heart failure patients; time to reconsider fluid restriction and prescribed diuretics ESC Heart Failure Thirst Heart failure Fluid restriction Sodium intake |
| title | Thirst in stable heart failure patients; time to reconsider fluid restriction and prescribed diuretics |
| title_full | Thirst in stable heart failure patients; time to reconsider fluid restriction and prescribed diuretics |
| title_fullStr | Thirst in stable heart failure patients; time to reconsider fluid restriction and prescribed diuretics |
| title_full_unstemmed | Thirst in stable heart failure patients; time to reconsider fluid restriction and prescribed diuretics |
| title_short | Thirst in stable heart failure patients; time to reconsider fluid restriction and prescribed diuretics |
| title_sort | thirst in stable heart failure patients time to reconsider fluid restriction and prescribed diuretics |
| topic | Thirst Heart failure Fluid restriction Sodium intake |
| url | https://doi.org/10.1002/ehf2.13960 |
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