Hydration improves symptoms of intermittent claudication

NewsBot · Feb 28, 2018

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Reversal of Lower Extremity Intermittent Claudication and Rest Pain by Hydration
Samuel Fernández et al
Annals of Vascular Surgery Article in Press

Background
Medical treatment of disabling intermittent claudication or critical limb threatening ischemia causing rest pain often fails or has partial response.

Methods
In this pilot study thirty-six patients (12 females) affected by disabling intermittent claudication or rest pain of the lower extremities were exposed to a daily 3 L water intake for up to six weeks. Cutaneous foot temperature, ankle/brachial index, time and distance of claudication and pain intensity were recorded before and at the completion of the hydration period.

Results
Patients with a mean ± SE age of 71 ± 2 years (range 40 - 86), had disabling claudication (less than a 100 meters) for more than five months while 11 % reported pain at rest. A six-week water intake of more than 2,500 mL/24 hours was achieved in 35 of the 36 patients enrolled in the study. Increased water intake was associated with significant improvements in median ankle/brachial index (from 0.60 to 0.76; p: <0.0001) and skin temperature (1st dorsal right toe from 29.95°C to 30.0°C, p < 0.001). Supervised treadmill exercise based on time and distance to report claudication improved from 100 meters to 535 meters (p <0.0001) and time to claudication from 1.25 to 6.25 minutes (p <0.0001).

Conclusions
This study suggests that hydration attained by daily water consumption of more than 2.5 L has a robust impact in reducing the symptoms of disabling claudication and rest pain caused by peripheral vascular disease.
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Admin2 · Feb 28, 2018

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NewsBot · Sep 29, 2020

Hydration may reverse most symptoms of lower extremity intermittent claudication or rest pain
Juan CarlosParodi et al
Journal of Vascular Surgery; Volume 72, Issue 4, October 2020, Pages 1459-1463

Background
Medical treatment of severe intermittent claudication or critical limb-threatening ischemia causing rest pain frequently achieves only partial relief or is not effective at all.

Methods
Patients with severe intermittent claudication or rest pain of the lower extremities who did not improve after control of risk factors, supervised exercises, and cilostazol medication were included in this study. All patients were treated with hydration. They were asked to drink 2500 mL of fluids (water, soup, milk) during a 24-hour period and to ingest 0.6 g/kg of albumin a day, as egg white or albumin powder. Total salt administered daily was 3.5 g. Symptoms, skin temperature, ankle-brachial index, albumin concentration in serum, and time and distance to claudication were recorded before treatment, at 6 weeks, and at 6 months. Electrolytes were measured monthly. No additional treatment was used during the study. Walking was encouraged but not supervised. The trial has continued indefinitely. For statistical analysis, SPSS software (IBM Corp, Armonk, NY) was used. The Ethical Committee approved the protocol, and an informed consent was signed by all patients.

Results
There were 132 patients (94 male, 38 female) included in the study. Median age was 72.5 years (range, 67-77 years); all had severe claudication of a mean of 100 meters or rest pain. Symptoms had been present for >5 months in all patients; 22 (16.8%) had rest pain. Proper hydration, determined as drinking at least 2000 mL of water during 24 hours for a period of 6 months, was achieved in 131 compliant patients. Only one patient failed to drink 2000 mL of water or more. Ankle-brachial index in 131 compliant patients improved from 0.6 to 0.75 (P < .0001) after 6 months. Skin temperature of the feet increased from 29.4°C to 31.7°C (P = .009). Distance to claudication using the treadmill improved from 100 meters to 535 meters (P < .0001) at 6 weeks and remained stable at 6 month in 65.83% of the patients; in 34.17% of them, distance to claudication increased further by 200 (100-500) meters and time to claudication improved from 1.3 to 6.3 minutes (P < .0001) at 6 weeks, but the same group of patients (34.17%) that increased the distance to claudication further prolonged the time to claudication by 2.49 (1.24-6.23) minutes. All 131 compliant patients improved their status related to lower extremity ischemia; the noncompliant patient did not have any variation of symptoms, skin temperature, ankle-brachial index, or time and distance to claudication. All patients survived the initial 6 months of treatment; afterward, three patients abandoned the treatment and four died of unrelated causes. After the 6-month control, 49% of the patients continued to improve the time and distance to claudication as well as the ankle-brachial index. The rest of the patients conserved the initial improvement. Five patients who had significantly improved the time and distance to claudication were asked to decrease water intake for 3 days. No changes in time and distance to claudication were detected. Hydration was reinitiated.

Conclusions
This study suggests that proper hydration by drinking ≥2000 mL of water daily and albumin complement orally to reach 4 g/dL in serum could be included in the armamentarium of physicians treating patients with disabling claudication or rest pain caused by peripheral artery disease. Further comparative studies to assess the benefit of hydration and increasing the serum oncotic pressure are warranted.
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Hydration improves symptoms of intermittent claudication

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Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

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Hydration improves symptoms of intermittent claudication

NewsBot The Admin that posts the news.

Admin2 Administrator Staff Member

NewsBot The Admin that posts the news.

Impact of hydration back packs on the running technique

Assessing skin hydration

The effect of hydration on the risk of friction blister formation

Toe stimulation improves tactile perception of the genitals

Lower extremity power training improves healthy old adults’ gait biomechanics

Adding an arch support to a heel lift improves stability and comfort during gait

Whole body vibration improves TcPO2 in the diabetic foot

Share This Page

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