The Effect Of Auricular Acupressure Intervention On Xerostomia And Interdialytic Weight Gain In Maintenance Hemodialysis Patients

ObjectiveXerostomia is one of the most common complaints on maintenance hemodialysis patients. Dry mouth can drive hemodialysis patients to excessive drinking, which may lead to excessive interdialytic weight gain (IDWG), increasing risk of death and poor prognosis. Therefore, the management of xerostomia is one of the important goals for hemodialysis patients. The aim of this study was to investigate the symptom of xerostomia in hemodialysis patients, then to assess the association of the scores of summated xerostomia inventory (SXI) with IDWG and daily IDWG. At last, assessed the effect of auricular acupressure on xerostomia and interdialytic weight gain through a pilot study.MethodsFirst, a cross-sectional survey was conducted to investigate the xerostomia on maintenance hemodialysis patients. Clinical data such as the primary cause of end-stage renal disease, pre-dialysis body weight, post-dialysis body weight, dry weight, pre-dialysis blood pressure, ultrafiltration volume and biochemical parameters were collected. Then, exploring the association of xerostomia with interdialytic weight gain and daily interdialytic weight gain. At last, eligible patients who were agreed to participate in this study were recruited and provided with auricular acupressure for 4 weeks. The summated xerostomia inventory was completed at baseline and after the 4-week treatment. IDWG, daily IDWG, blood pressure and biochemical parameters were measured at baseline and after a 4-week treatment on mid-week hemodialysis session.ResultsThere were 135 maintenance hemodialysis patients (male:63, female:73, mean age:56.94±14.43 years) who agreed to take part in the investigation. The mean dialysis vintage of the patients was 65.46±46.04 months. The mean IDWG was 2.55±0.95 kg and the mean daily IDWG was 1.08±0.42 kg. After the survey, we found that the mean summated xerostomia inventory scores was 9.42±2.01. The xerostomia inventory scores had a positive relation with IDWG (r=0.24, p＜0.05) and daily IDWG(r=0.26, p＜0.05). A total of 26 eligible participants (10 men,16 women, mean age:52.92±11.8 years, dialysis vintage: 81.86±46.05 months) were recruited. The primary cause of end-stage renal disease was glomerulonephritis (69.23%), hypertension (19.23%), diabetes (7.69%) and nephrotic syndrome (3.85%). After 4-week auricular acupressure intervention, the SXI scores were significantly decreased compared to baseline (from 10.08±2.26 at baseline to 9.04±2.14 after intervention, p＜0.05). But the mean IDWG, daily IDWG, blood pressure and biochemical parameters didn’t change significantly during the intervention period (p＞0.05), except for the serum sodium and serum hemoglobin(p＜0.05).GonelusionThe xerostomia inventory scores had a positive relation with IDWG and daily IDWG. This study provided preliminary evidence that AAT may be effective in reducing xerostomia intensity on MHD patients.