Analysis Of Clinical Features And Influencing Factors Of Dialysis Headache In Soochow Area

Objective:The first part is to analyze the clinical features of dialysis headache and to explore the relevant factors that affect dialysis headache.The second part is to study the clinical features of dialysis headache,including headache features,headache impact and life quality.Methods:Clinical data of 275 end-stage renal disease(ESRD)patients who were admitted to the hemodialysis center of the First Affiliated Hospital of Soochow University,Suzhou Hospital of Traditional Chinese Medicine and the First People’s Hospital of Wujiang District from March 2018 to February 2019 were collected.They were divided into dialysis headache group and non-dialysis headache group.Clinical characteristics of age,gender,dialysis time,blood pressure,weight difference before and after dialysis,urea nitrogen,hemoglobin,creatinine,electrolytes,parathyroid hormone,albumin,fasting blood glucose,C-reactive protein,self-rating depression scale,Pittsburgh sleep quality index were statistically analyzed by univariate and multivariate analysis.The headache characteristics of dialysis headache patients were analyzed,including time of onset,duration,range of pain,location of pain,degree of pain,nature of pain,and accompanying symptoms.Headache impact test-6(HIT-6)was used to assess the headache impact of dialysis headache.The 12-items Short Form Health Survey(SF-12)was used to assess the life quality of hemodialysis patients.A total of 212 migraine patients who were treated in the neurology department of the First Affiliated Hospital of Soochow University in the same period were used as controls to analyze the differences of HIT-6 and SF-12 scores between dialysis headache and migraine.Results:1.Analysis of the prevalence and relevant factors of dialysis headacheDialysis headache occurred in 46(16.73%)of 275 patients with ESRD.Systolic blood pressure before dialysis,diastolic blood pressure before dialysis,systolic blood pressure after dialysis,diastolic blood pressure after dialysis,weight difference,urea before dialysis,urea after dialysis,and serum sodium were higher in dialysis headache patients(P<0.05).Further multivariate analysis indicated that systolic blood pressure before dialysis(OR 1.045 95%CI 1.005～1.086),weight difference(OR 2.070 95%CI 1.072～3.998),and serum sodium(OR 1.376 95%CI 1.177～1.609)of dialysis headache patients and non-dialysis headache patients had statistical differences(P<0.05).2.Analysis of headache characteristics of dialysis headacheDialysis headache appeared more frequently during the first 3 hours of hemodialysis and lasted less then 4 hours in the majority of dialysis headache patients.In the majority of patients,headache was bilateral,slight,non-pulsating,without accompanying symptoms and it appeared mostly in forehead.The relatively common accompanying symptom was nausea.3.Analysis of headache impact of dialysis headache and migraineDialysis headache patients had higher Q3 scores.Patients" vitality was greatly affected.78.26%of patients suffered from no or less headache impact.And only 10.87%of patients were severely affected.Compared with migraine patients,there was no difference in Q1 and Q4 scores(P>0.05).The scores of Q2,Q3,Q5 and Q6 in dialysis headache patients were lower than those in migraine patients(P<0.05).There was no significant difference in the severity of the headache and the role function.The impact of social function,vitality,psychological distress and attention in dialysis headache patients were less than those of migraine patients.The overall impact of dialysis headache patients was less than that of migraine patients.4.Analysis of life quality of dialysis headache,ESRD without headache,and migraineDialysis headache patients had lower PCS scores than ESRD patients without headache(P<0.05).There was no significant difference in MCS scores between the two groups(P>0.05).The physical health status of dialysis headache patients was worse than that of ESRD patients without headache,and there was no significant difference in mental health status between the two groups.Dialysis headache patients had lower PCS scores and MCS scores than migraine patients(P<0.05).The physical health status and mental health status of dialysis headache patients were worse than those of migraine patients.Conclusion:1.The prevalence of dialysis headache in this study was 16.73%.2.Systolic blood pressure before dialysis,weight difference,and serum sodium were relevant factors of dialysis headache.3.Most dialysis headache patients suffered from no or less headache impact.Limited physical activity was the main reason.4.ESRD patients with dialysis headache had worse physical health status.The physical health status and mental health status of dialysis headache patients were worse than those of migraine patients.