title: Chewing gum and a saliva substitute alleviate thirst and xerostomia in patients on haemodialysis.
abstract: BACKGROUND
  Most patients on haemodialysis (HD) have to maintain a fluid-restricted diet to prevent a high interdialytic weight gain (IWG). The prevalence of xerostomia (the feeling of a dry mouth) is higher in HD patients than in controls. Recently, we demonstrated that xerostomia and thirst were positively correlated with IWG in HD patients. Thus, this may play a role as a stimulus for fluid intake between dialysis sessions. The aim of the present study was to investigate the effect of chewing gum or a saliva substitute on xerostomia, thirst and IWG.
  
  
  METHODS
  This study was a randomized two-treatment crossover design with repeated measures. After the use of chewing gum or saliva substitute for 2 weeks, a wash-out period of 2 weeks was introduced and hereafter the other regimen was carried out. Xerostomia and thirst were assessed by validated questionnaires as xerostomia inventory (XI) and dialysis thirst inventory (DTI), at baseline and after each treatment period, as were IWG and salivary flow rates.
  
  
  RESULTS
  Sixty-five HD patients (42 men, 54.6+/-14.1 years; 23 women, 54.7+/-16.3 years) participated in this study. Chewing gum decreased XI from 29.9+/-9.5 to 28.1+/-9.1 (P<0.05). Chewing gum as well as a saliva substitute reduced DTI significantly (P<0.05), but no differences occurred for the average IWG or salivary flow rates.
  
  
  CONCLUSIONS
  The use of chewing gum and, to a lesser extent, a saliva substitute may alleviate thirst and xerostomia in some HD patients.
authors.affiliation: Department of Oral Biochemistry, Academic Center for Dentistry, Amsterdam, The Netherlands. c.bots@vumc.nl
authors.forename: Casper P
authors.initials: CP
authors.lastname: Bots
authors.forename: Henk S
authors.initials: HS
authors.lastname: Brand
authors.forename: Enno C I
authors.initials: EC
authors.lastname: Veerman
authors.forename: Johanna C
authors.initials: JC
authors.lastname: Korevaar
authors.forename: Marianne
authors.initials: M
authors.lastname: Valentijn-Benz
authors.forename: Pieter D
authors.initials: PD
authors.lastname: Bezemer
authors.forename: Robert M
authors.initials: RM
authors.lastname: Valentijn
authors.forename: Pieter F
authors.initials: PF
authors.lastname: Vos
authors.forename: Joost A
authors.initials: JA
authors.lastname: Bijlsma
authors.forename: Piet M
authors.initials: PM
authors.lastname: ter Wee
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Van Amerongen
authors.forename: Arie V
authors.initials: AV
authors.lastname: Nieuw Amerongen
mesh_terms: D000328:Adult; D000368:Aged; D002638:Chewing Gum; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D006435:Renal Dialysis; D012464:Saliva, Artificial / Q000627:therapeutic use*; D012472:Salivation / Q000187:drug effects; D013894:Thirst / Q000187:drug effects*; D015430:Weight Gain / Q000187:drug effects; D014987:Xerostomia / Q000209:etiology / Q000517:prevention & control*
chemical_list: D002638:Chewing Gum; D012464:Saliva, Artificial; C434189:xialine