Impact of Thirst Perception on Health-Related Quality of Life in Hemodialysis Patients: A Multicenter Study.

Abstract

Introduction: Thirst distress is a common yet underexplored symptom among hemodialysis (HD) patients, with limited understanding of its impact on quality of life. This study aims to evaluate thirst perception, identify factors associated with its intensity, and examine its relationship with quality of life in a multicenter cohort of HD patients.

Methods: This cross-sectional analysis utilized baseline data from the Hemodiafiltration on Physical Activity and Self-Reported Outcomes: A Randomized Controlled Trial (HDFit). Participants were over 18 years old from 13 dialysis units across Brazil. Thirst perception was assessed using the Dialysis Thirst Inventory (DTI) questionnaire, and health-related quality of life (HRQoL) was measured with the SF-36 questionnaire. We compared participants with low versus high thirst perception based on the median DTI score and conducted multiple regression analysis to identify independent determinants of physical and mental HRQoL components.

Findings: The study sample comprised 195 patients (male: 71%; median age: 54 [41-66] years; 29% with diabetes) from 13 dialysis centers, with chronic HD duration up to 24 months. The median DTI score was 17 (14-22). Participants with higher thirst perception (DTI > 17) were younger, had a higher prevalence of lower income and educational levels, and a lower prevalence of fluid overload. Multiple regression analysis, adjusted for demographic, clinical, and nutritional variables, revealed that increased thirst perception was independently associated with poorer physical and mental HRQoL.

Conclusion: In a multicenter HD population, higher thirst perception was an independent determinant of diminished health-related quality of life.