ReviewPerioperative medicine (London, England)2018
The sensitivity of the human thirst response to changes in plasma osmolality: a systematic review.
Review in Perioperative medicine (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.
- Demographic, perioperative, biochemical and illness-severity predictors of thirst in critically ill patients: a systematic review and meta-analysis.Internal medicine journal · 2026Pooled it
- Ultrafiltration-sodium profiles and their impact on thirst and xerostomia in hemodialysis patients.Scientific reports · 2025Trial
- Rehydration effect of qingshu buye decoction on exercise and high temperature-induced dehydration.Journal of the International Society of Sports Nutrition · 2024Trial
- Trial
- Inadequate fluid replacement during prolonged cycling in the heat impairs time trial performance independent of serum sodium concentrations.European journal of applied physiology · 2026Article
- Can We Protect Our Hearts by Sweating Out Excess Sodium?Exercise and sport sciences reviews · 2026Review
- Trajectories of oral mucosal dryness and multidimensional influencing factors in patients undergoing spine surgery: a prospective longitudinal study.BMC oral health · 2026Article
- Revisiting the need for innovative oral hydration technologies.Frontiers in nutrition · 2026Review
- Perspectives on enhancing human performance in the heat: Is the solution to simply "just add water"?Sports medicine and health science · 2025Review
- How to Limit Interdialytic Weight Gain in Patients on Maintenance Hemodialysis: State of the Art and Perspectives.Journal of clinical medicine · 2025Review
- Inflammation and vasopressin hypersecretion in aging.Frontiers in endocrinology · 2025Review
- Arginine vasopressin and copeptin: comparative review and perspective in veterinary medicine.Frontiers in veterinary science · 2025Review
- Is mild dehydration a risk for progression of childhood chronic kidney disease?Pediatric nephrology (Berlin, Germany) · 2024Review
- Hypodipsic hypernatremia after long-standing polydipsia in a cat with suspect neonatal head trauma.The Canadian veterinary journal = La revue veterinaire canadienne · 2023Article
- Article
- Cross-cultural variation in thirst perception in hot-humid and hot-arid environments: Evidence from two small-scale populations.American journal of human biology : the official journal of the Human Biology Council · 2022Article
- Hyponatraemia and hypernatraemia: Disorders of Water Balance in Neurosurgery.Neurosurgical review · 2021Review
- Fluid Intake Recommendation Considering the Physiological Adaptations of Adults Over 65 Years: A Critical Review.Nutrients · 2020Review
- Thirst in patients on chronic hemodialysis: What do we know so far?International urology and nephrology · 2020Review
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDehydration is highly prevalent and is associated with adverse cardiovascular and renal events. Clinical assessment of dehydration lacks sensitivity. Perhaps a patient's thirst can provide an accurate guide to fluid therapy. This systematic review examines the sensitivity of thirst in responding to changes in plasma osmolality in participants of any age with no condition directly effecting their sense of thirst.
methodsMedline and EMBASE were searched up to June 2017. Inclusion criteria were all studies reporting the plasma osmolality threshold for the sensation of thirst.
resultsA total of 12 trials were included that assessed thirst intensity on a visual analogue scale, as a function of plasma osmolality (pOsm), and employed linear regression to define the thirst threshold. This included 167 participants, both healthy controls and those with a range of pathologies, with a mean age of 41 (20-78) years.The value ±95% CI for the pOsm threshold for thirst sensation was found to be 285.23 ± 1.29 mOsm/kg. Above this threshold, thirst intensity as a function of pOsm had a mean ± SEM slope of 0.54 ± 0.07 cm/mOsm/kg. The mean ± 95% CI vasopressin release threshold was very similar to that of thirst, being 284.3 ± 0.71 mOsm/kg.Heterogeneity across studies can be accounted for by subtle variation in experimental protocol and data handling.
conclusionThe thresholds for thirst activation and vasopressin release lie in the middle of the normal range of plasma osmolality. Thirst increases linearly as pOsm rises. Thus, osmotically balanced fluid administered as per a patient's sensation of thirst should result in a plasma osmolality within the normal range. This work received no funding.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.