ABNORMALITIES OF THIRST REGULATION IN PATIENTS WITH CHRONIC-RENAL-FAILURE ON HEMODIALYSIS
ABNORMALITIES OF THIRST REGULATION IN PATIENTS WITH CHRONIC-RENAL-FAILURE ON HEMODIALYSIS
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DOI：
10.1159/000168421
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发表时间：
1992-01-01
影响因子：
4.2
通讯作者：
OLIVER, JA
中科院分区：
文献类型：
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作者：
MARTINEZVEA, A;GARCIA, C;OLIVER, JA
为了确定在接受血液透析的慢性肾衰竭非糖尿病患者中口渴机制是否改变，4名透析期间平均体重增加超过干体重5%的患者（组1），5名体重增加小于3%的患者（组II）和一组6名健康受试者（组III）接受高渗盐水输注。输注后，受试者可自由饮水。通过视觉模拟评定量表评估口渴。尽管输注生理盐水期间有效血浆渗透压增加相似，但I组患者比II组和III组更口渴（分别为p < 0.005和p < 0.01）。组II和组III中口渴等级的变化相似。第II组和第III组中口渴发作的渗透阈值相似（分别为288.9 +/- 8.5和289.8 +/- 3.4 mosm/kg），但第I组较低（277.6 +/- 7.6 mosm/kg）。然而，在后一组中观察到很大的差异。因此，2例患者的口渴阈值在正常范围内，而其他患者的口渴阈值和基线血浆渗透压较低，基础口渴评分较高。在饮酒期间，组I的患者饮酒（14.2 +/-2.8ml/kg）多于组II（5.3 +/-1.6ml/kg; p < 0.02）和组III（10.2 +/-1.6ml/kg;，n.s.）尿毒症患者的血浆血管紧张素II水平高于健康受试者，但I组和II组之间无差异，基础血管紧张素II水平与透析间期体重增加之间无相关性。我们的研究结果表明，一些慢性肾功能衰竭的血液透析患者表现出过度口渴和增加更多的体重之间的透析会议。这种干扰可以介导的重置口渴调节器，虽然一个明显的原因是不明显的，在所有的患者。
To determine whether thirst mechanisms are altered in nondiabetic patients with chronic renal failure on hemodialysis, 4 patients with an average weight gain between dialysis sessions of more than 5% of dry body weight (group 1), 5 patients with less than 3% weight gain (group II), and a group of 6 healthy subjects (group III) were submitted to infusion of hypertonic saline. After infusion the subjects had free access to water. Thirst was evaluated by visual analogue rating scales. Despite similar increments of effective plasma osmolalIty during saline infusion, patients of group I were thirstier than groups II and III (p < 0.005 and p < 0.01, respectively). Changes in thirst ratings were similar in groups II and III. Osmotic thresholds for thirst onset were similar in groups II and III (288.9 +/- 8.5 and 289.8 +/- 3.4 mosm/kg, respectively), but lower in group I (277.6 +/- 7.6 mosm/kg). Nevertheless, great variations were observed in the latter group. Thus, 2 patients showed thresholds for thirst within the normal range, whereas the others had low osmolar thresholds for thirst and baseline plasma osmolalities and high basal thirst scores. During the drinking period, the patients of group I drank more (14.2 +/- 2.8 ml/kg) than those of groups II (5.3 +/-1.6 ml/kg; p < 0.02) and III (10.2 +/- 1.6 ml/kg;, n.s.) The plasma levels of angiotensin II in uremic patients were higher than in healthy subjects, although there were no differences between groups I and II and no correlation between basal angiotensin II levels and the interdialytic weight gain. Our results indicate that some patients with chronic renal failure on hemodialysis manifest excessive thirst and gain more weight between dialysis sessions. This disturbance could be mediated by a resetting of the thirst osmostat, although an apparent cause of hyperdipsia was not evident in all patients.