A cross-sectional study of fatigue and sleep quality before and after kidney transplantation

Abstract

Fatigue and sleep disturbances are common problems for adults with chronic kidney disease or end-stage renal disease. However, these issues have not been examined much in the context of kidney transplantation (KTx). This study characterizes these outcomes in the KTx population and examines their association with psychological functioning and quality of life (QOL). A cross-sectional cohort of 100 wait-listed pre-KTx and 100 post-KTx patients at one transplant center in the United States completed validated fatigue, sleep, mood, and QOL questionnaires, and their medical records were reviewed. Pre-KTx patients had higher levels of fatigue frequency, fatigue severity, and fatigue disruptiveness than post-KTx patients. Also, pre-KTx patients had more difficulty with sleep quality, latency, duration, efficiency, and disturbance and were more likely to have "poor" sleep quality compared with post-KTx patients. Multivariate predictors of high fatigue severity for both pre- and post-KTx patients were high body mass index (BMI), poor sleep quality, and mood disturbance, while poor sleep quality was predicted by high BMI and mood disturbance. Most sociodemographic and clinical parameters were not associated with fatigue severity or sleep disturbance. Fatigue and sleep disturbances are common before and after KTx, and study findings have important implications for their assessment and management.

Severe fatigue after kidney transplantation: a highly prevalent, disabling and multifactorial symptom

“…Depressive symptoms and sleeping problems were most strongly related to severe fatigue, while the other assessed factors were no longer significant in multivariate analysis. Our finding that severe fatigue was related to depressive symptoms, sleeping problems and also overweight is in accordance with the study of Rodrigue et al [6]. The prevalence of obesity in our sample (13%) seems to lie in the same range as the Dutch population (11% in 2011) [41].…”

“…We found that as many as 39% of the recipients were severely fatigued compared with 22% of the sex-and age-matched population-based control group. Our results revealed a lower percentage of severe fatigue than previously found in comparison to healthy individuals [6]. The discrepancy could be explained by the fact that a different questionnaire was used, and that the chosen cut-off score was determined with a different method.…”

“…Even though fatigue seems to decrease after kidney transplantation, sparse studies indicate that kidney transplant recipients (KTRs) experience more fatigue than healthy controls [7,8]. Rodrigue et al [6] even classified 59% of recipients with high fatigue severity, based on an earlier defined cutoff score for clinically relevant fatigue determined in a sample of healthy women [9].…”

A Novel Application of a Biopsychosocial Theory in the Understanding of Disturbed Sleep before and after Kidney Transplantation

“…The combination of reduced activity and increased fatigue can lead to increased idle time in bed and is likely related to mood disturbance. 20,22 Insomnia is maintained by perpetuating factors, which may include changes individuals make in their sleep/wake schedules or daytime behaviors (e.g., stimulant use and napping) as they attempt to compensate for sleeping poorly. 20 Specifically, daytime naps may disrupt the sleep homeostat (drive for sleep that increases the longer one is awake) by meeting some of the sleep drive that typically builds during the day.…”

Structural Equation Modeling on Quality of Life in Pre-dialysis Patients with Chronic Kidney Disease

“…또한 우울 (Kalender, Ozdemir, Dervisoglu, & Ozdemir, 2007), 불안 (Tong et al, 2009), 피로 (Rodrigue et al, 2011), 수면 장애 (Cohen, Patel, Khetpal, Peterson, & Kimmel, 2007)와 같은 생행동적 요인이 삶의 질에 부정적인 영향 을 미치는 것으로 보고되었으며 (Wood, Klebba, & Miller, 2000), 사회 적 지지 또한 만성 신부전 환자의 삶의 질에 직접적 (Cohen et al) 또 는 간접적으로 영향을 주는 것으로 보고되었다 (Hoth, Christensen, Ehlers, Raichle, & Lawto, 2007). 영양학적, 신체적 요인은 수면장애 (Cohen et al), 우울 (Kohatsu, 2005) …”