Assessment of Fatigue in End Stage Renal Disease Patients Undergoing Hemodialysis: Prevalence and Associated Factors

Zyga, Sofia; Alikari, Victoria; Sachlas, Athanasios; Fradelos, Εvangelos C.; Stathoulis, John; Panoutsopoulos, Georgios I.; Georgopoulou, Maria; Theophilou, Paraskeui; Lavdaniti, Maria

doi:10.5455/medarh.2015.69.376-380

Cited by 60 publications

(59 citation statements)

References 36 publications

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“…Importantly, we ascertained fatigue using 3 different validated self-report scales, one of which accounts for the severity of symptoms. Interestingly, even in this cohort with earlier stages of CKD-ND, we showed that fatigue is prevalent in 69.2% of patients by the QIDS-SR 16 and 77.7% by the BDI-I, which is comparable to the prevalence seen in ESRD samples [2,22,23]. This contradicts conventional wisdom among nephrologists that those with CKD-ND, particularly at earlier stages before the incidence of uremia, have lower symptom burden than those who require maintenance dialysis.…”

Section: Discussioncontrasting

confidence: 43%

“…Although increased prevalence of fatigue has been recognized in multiple chronic diseases including CKD-D [1][2][3]21], data are scarce in CKD-ND samples with earlier stages of CKD before frank uremic symptoms begin to manifest. Several studies have shown that approximately 70% of hemodialysis and peritoneal dialysis patients report fatigue [2,22,23]. One study showed a prevalence of 82.0% in CKD stage 5 patients who either declined or were not offered dialysis, compared to 67.8% in those receiving dialysis [24].…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, investigation of clinical characteristics associated with the presence of fatigue at earlier CKD stages may lead to identification of potentially modifiable risk factors. Prior studies have identified multiple factors associated with the presence of fatigue in CKD-D patients, including non-black race, medical comorbidities, diabetes, low serum albumin, use of sleep medication, urban living, unemployed status, low education level, low hemoglobin, anorexia, physical inactivity, depression, and chronic inflammation [2,8,9,23,27]. One study investigating a combined sample of CKD-ND and hemodialysis patients determined that a history of cardiovascular disease, low albumin, depressive symptoms, poor sleep quality, daytime sleepiness, and restless leg syndrome were all associated with fatigue after adjusting for age, sex, race, dialysis status, and use of antidepressants or benzodiazepines [4].…”

Section: Discussionmentioning

confidence: 99%

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Fatigue in Nondialysis Chronic Kidney Disease: Correlates and Association with Kidney Outcomes

et al. 2019

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Background: Fatigue, although common and associated with outcomes in dialysis-dependent chronic kidney disease (CKD), has not been studied in nondialysis chronic kidney disease (CKD-ND) patients. Methods: In this longitudinal cohort of 266 outpatients with CKD-ND stages 2–5, we measured self-reported fatigue on 3 scales-Quick Inventory of Depression Symptomatology-Self Report (QIDS-SR₁₆), Beck Depression Inventory-I (BDI-I), and short form 12 health survey (SF-12) questionnaires and evaluated the prespecified composite of progression to dialysis initiation, death, or hospitalization after 12 months. Logistic and linear regression assessed characteristics associated with fatigue. Survival analysis measured associations of fatigue with outcomes. Results: Mean age was 64.4 ± 12.0 years, and mean estimated glomerular filtration rate (eGFR) was 31.6 ± 16.7 mL/min/1.73 m². Fatigue was common, with 69.2% reporting fatigue on QIDS-SR₁₆ and 77.7% on BDI-I. Unemployment, comorbidities, use of antidepressant medications, and lower hemoglobin correlated with fatigue. There were 126 outcome events. Participants that reported any versus no fatigue on QIDS-SR₁₆ were more likely to reach the composite, hazard ratio (HR) 1.70 (95% CI 1.11–2.59), which persisted after adjusting for demographics, comorbidities, substance abuse, hemoglobin, albumin, eGFR, and calcium-phosphorus product, HR 1.63 (1.05–2.55). Fatigue severity by the SF-12 was also associated with outcomes independent of demographics, comorbidities, and substance abuse, HR per unit increase 1.18 (1.03–1.35). No association was observed with fatigue on the BDI-I. Conclusion: Fatigue affected about 2/3 of CKD-ND patients and associated with unemployment, comorbidities, antidepressant medication use, and anemia. Fatigue measured by the QIDS-SR₁₆ and SF-12 independently predicted outcomes in CKD patients. Eliciting the presence of fatigue may be a clinically significant prognostic assessment in CKD patients.

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Section: Discussioncontrasting

confidence: 43%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Fatigue in Nondialysis Chronic Kidney Disease: Correlates and Association with Kidney Outcomes

et al. 2019

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“…6 They also suffer from insomnia, 7 poor sleep quality, 8 sexual dysfunction, 9 and fatigue. 10 Therefore, they have to change their daily life similar to the patients with other chronic diseases. 11 Girija and Radha investigated elderly individuals under hemodialysis and stated that their hope levels were lower compared to the adults under the same circumstances.…”

Section: Introductionmentioning

confidence: 99%

<p>The Effect of Peer Support on Hope Among Patients Under Hemodialysis</p>

Pasyar¹,

Rambod²,

Jowkar³

2020

IJNRD

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Introduction: Providing social support for patients under hemodialysis treatment can reduce their psychological, social, and physical problems. The present study aimed at determining the effect of peer support on hopefulness in patients under hemodialysis. Methods: This clinical trial with a pre/posttest design was conducted on 128 patients who had referred to the hemodialysis centers of Shiraz University of Medical Sciences in 2019. The patients were randomly divided into an intervention and a control group. The patients in the intervention group were supported by their peers for eight weeks and were provided with the usual care, but the controls were only provided with the usual care. The data were collected using Snyder Hope Scale. Then, the data were entered into the SPSS software, version 18 and were analyzed using independent t-test and paired t-test. Results: At baseline, the participants in both groups were similar with respect to the mean scores of hope and its subscales (p>0.05). However, there was a significant difference between the two groups in terms of hope and its subscales eight weeks after the intervention (p<0.001). Conclusion: The results confirmed the effect of peer support on increasing hope among the patients under hemodialysis. Peer support in informational, emotional, instrumental, and spiritual forms could create a positive incentive and increase hope among the patients. Clinical Trial Number: This clinical trial has been registered in the Iranian Registry of Clinical Trials (IRCT20190126042498N1).

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“…In national and international studies, fatigue has been reported in more than half of hemodialysis patients (6,9,10). For fatigue, hemodialysis patients are now recommended using vitamin C supplement (6), acupressure (11), and back massage (12).…”

Section: Introductionmentioning

confidence: 99%

Investigating the Impact of Foot Reflexology on Severity of Fatigue in Patients Undergoing Hemodialysis: A Clinical Trial Study

et al. 2018

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Background:Fatigue is a debilitating complication in hemodialysis patients. Foot reflexology is one of the complementary medicine techniques with low complications that can control fatigue. Objectives: The aim of this study was to determine the effect of foot reflexology massage on fatigue severity in hemodialysis patients. Methods: In this clinical trial, 90 patients undergoing hemodialysis at Ali ibn Abi Talib hospital in Zahedan, Iran, in 2017 were randomly selected and then divided into two groups of intervention and control (n = 45 per group). The data collection tools included a demographic checklist and the fatigue severity scale developed by Krupp et al. Foot reflexology massage was performed in the intervention group for half an hour (15 minutes for each foot) by a trained researcher for three consecutive dialysis sessions. After completion of dialysis sessions, a questionnaire was completed as post-test in both groups. For data analysis, independent t-test, paired t-test, and chi-square test were run in SPSS, version 21. Results: There was no significant difference in the mean fatigue scores between the control and intervention groups before foot reflexology massage in the three sessions of dialysis. After the intervention, the independent t-test showed a significant difference in the mean fatigue score between the control and intervention groups (P < 0.001). Conclusions:The findings of this study showed that foot reflexology massage is an uncomplicated technique for reducing fatigue severity in patients undergoing hemodialysis.

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Assessment of Fatigue in End Stage Renal Disease Patients Undergoing Hemodialysis: Prevalence and Associated Factors

Cited by 60 publications

References 36 publications

Fatigue in Nondialysis Chronic Kidney Disease: Correlates and Association with Kidney Outcomes

Fatigue in Nondialysis Chronic Kidney Disease: Correlates and Association with Kidney Outcomes

<p>The Effect of Peer Support on Hope Among Patients Under Hemodialysis</p>

Investigating the Impact of Foot Reflexology on Severity of Fatigue in Patients Undergoing Hemodialysis: A Clinical Trial Study

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