Effects of Electrical Stimulation of Acupoints on Xerostomia for Patients Who Undergo Hemodialysis

Xerostomia plays a major role in higher interdialytic weight gain (IDWG), which causes cardiovascular complications in patients who undergo hemodialysis. However, few studies have determined a method to manage xerostomia. This study determines the effect of transcutaneous electrical acupoint stimulation (TEAS) on hemodialysis patients with xerostomia and the percentage of IDWG. The study was a single-blind and quasi-experimental study. There are 75 participants: 37 in the TEAS group and 38 in the contrast group. The TEAS group used 250 µs and 50 Hz and the contrast group used 50 µs and 2 Hz three times a week for 3 weeks to stimulate ST 6 and TE17 acupoints. The salivary flow rates, dry mouth, and %IDWG were determined before, during and one week after the program. Compared with the contrast group, the TEAS group showed a significantly improved salivary flow rate (mL/min) (F (2, 123) = 15.28, p < 0.0001), and patients recovered their normal salivary flow rate. However, the results show that both groups showed significant improvement in dry mouth after treatment. The TEAS group demonstrated no effect in terms of %IDWG, as expected. The results show that a TEAS program is an effective means of symptom management for xerostomia patients who undergo hemodialysis. A TEAS program can be used to manage symptoms for xerostomia patients who undergo hemodialysis.

[1]  Peipei Hong,et al.  Acupuncture for the treatment of radiation-induced xerostomia among patients with cancer:A protocol for a systematic review and meta-analysis. , 2020 .

[2]  C. Chin,et al.  The effect of transcutaneous electrical nerve stimulation on increasing salivary flow rate in hemodialysis patients. , 2018, Oral diseases.

[3]  A. Bruzda-Zwiech,et al.  Xerostomia, thirst, sodium gradient and inter-dialytic weight gain in hemodialysis diabetic vs. non-diabetic patients , 2018, Medicina oral, patologia oral y cirugia bucal.

[4]  M. Hegde,et al.  Evaluation of salivary parameters and dental status in adult hemodialysis patients in an indian population , 2018, Journal of clinical and experimental dentistry.

[5]  S. Zyoud,et al.  Treatment adherence and perception in patients on maintenance hemodialysis: a cross – sectional study from Palestine , 2017, BMC Nephrology.

[6]  Ciyong Lu,et al.  Poor sleep and reduced quality of life were associated with symptom distress in patients receiving maintenance hemodialysis , 2016, Health and Quality of Life Outcomes.

[7]  I. Eser,et al.  The Null Effect of Chewing Gum During Hemodialysis on Dry Mouth , 2016, Clinical nurse specialist CNS.

[8]  N. Foley,et al.  Meta‐Analysis of Salivary Flow Rates in Young and Older Adults , 2015, Journal of the American Geriatrics Society.

[9]  A. Libório,et al.  Hemodialysis-specific factors associated with salivary flow rates. , 2015, Artificial organs.

[10]  A. Villa,et al.  Diagnosis and management of xerostomia and hyposalivation , 2014, Therapeutics and clinical risk management.

[11]  S. Rao,et al.  Evaluation of effect of transcutaneous electrical nerve stimulation on salivary flow rate in radiation induced xerostomia patients: a pilot study. , 2015, Journal of cancer research and therapeutics.

[12]  J. Krithikadatta Normal Distribution , 2014, Journal of conservative dentistry : JCD.

[13]  Yong Gu,et al.  Study on the Clinical Significance and Related Factors of Thirst and Xerostomia in Maintenance Hemodialysis Patients , 2013, Kidney and Blood Pressure Research.

[14]  A. Bruzda-Zwiech,et al.  Sodium gradient, xerostomia, thirst and inter-dialytic excessive weight gain: a possible relationship with hyposalivation in patients on maintenance hemodialysis , 2013, International Urology and Nephrology.

[15]  R. Curtis,et al.  Factors influencing adherence among Irish haemodialysis patients. , 2013, Patient education and counseling.

[16]  A. Kaushik,et al.  Oral and salivary changes among renal patients undergoing hemodialysis: A cross-sectional study , 2013, Indian journal of nephrology.

[17]  M. Darawad,et al.  Predictors of dietary and fluid non-adherence in Jordanian patients with end-stage renal disease receiving haemodialysis: a cross-sectional study. , 2013, Journal of clinical nursing.

[18]  L. Salman,et al.  Cardiovascular Implantable Electronic Device Leads in CKD and ESRD Patients: Review and Recommendations for Practice , 2013, Seminars in dialysis.

[19]  M. Bossola,et al.  Xerostomia in patients on chronic hemodialysis , 2012, Nature Reviews Nephrology.

[20]  Mark I. Johnson,et al.  The characteristics of acupuncture-like transcutaneous electrical nerve stimulation (acupuncture-like TENS): a literature review. , 2011, Acupuncture & electro-therapeutics research.

[21]  P. Yates,et al.  Effect of Acupressure on Thirst in Hemodialysis Patients , 2010, Kidney and Blood Pressure Research.

[22]  N. Levin,et al.  Interdialytic weight gain: implications in hemodialysis patients. , 2006, Seminars in dialysis.

[23]  B. Maes,et al.  Nonadherence with diet and fluid restrictions among adults having hemodialysis. , 2005, Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing.

[24]  Istvan A Hargitai,et al.  The effects of electrostimulation on parotid saliva flow: a pilot study. , 2005, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[25]  J. Korevaar,et al.  Chewing gum and a saliva substitute alleviate thirst and xerostomia in patients on haemodialysis. , 2005, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[26]  J. Bijlsma,et al.  Interdialytic weight gain in patients on hemodialysis is associated with dry mouth and thirst. , 2004, Kidney international.

[27]  M. Flanigan HYPERTENSION IN HEMODIALYSIS PATIENTS: Dialysate Composition and Hemodialysis Hypertension , 2004, Seminars in dialysis.

[28]  C. Dawes,et al.  How Much Saliva Is Enough for Avoidance of Xerostomia? , 2004, Caries Research.

[29]  C. Zoccali,et al.  Salivary and lacrimal secretion is reduced in patients with ESRD. , 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[30]  T. Whelan,et al.  A Phase I-II study in the use of acupuncture-like transcutaneous nerve stimulation in the treatment of radiation-induced xerostomia in head-and-neck cancer patients treated with radical radiotherapy. , 2003, International journal of radiation oncology, biology, physics.

[31]  W. L. Kenney,et al.  Influence of age on thirst and fluid intake. , 2001, Medicine and science in sports and exercise.

[32]  L. Dawson,et al.  Xerostomia and its predictors following parotid-sparing irradiation of head-and-neck cancer. , 2001, International journal of radiation oncology, biology, physics.

[33]  T. Lundeberg,et al.  Long-term follow-up of patients treated with acupuncture for xerostomia and the influence of additional treatment. , 2008, Oral diseases.

[34]  B. Angmar-Månsson,et al.  Acupuncture treatment of patients with radiation-induced xerostomia. , 1996, European journal of cancer. Part B, Oral oncology.

[35]  T. Yao Acupuncture and somatic nerve stimulation: mechanism underlying effects on cardiovascular and renal activities. , 1993, Scandinavian journal of rehabilitation medicine. Supplement.

[36]  J. A. Oliver,et al.  Abnormalities of thirst regulation in patients with chronic renal failure on hemodialysis. , 1992, American journal of nephrology.