Factors related to fatigue in Chinese patients with end-stage renal disease receiving maintenance hemodialysis: a multi-center cross-sectional study

Wang, Siyuan; Zang, Xiaoying; Fu, Sheng-Hui; Bai, Jinbing; Liu, Junduo; Tian, Li; Feng, Yuying; Zhao, Yue

doi:10.3109/0886022x.2016.1138819

Cited by 45 publications

(53 citation statements)

References 48 publications

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“…Recognizing that associated factors differ based on which scale was used to measure fatigue highlights the complexity of measuring fatigue for research or clinical purposes and reinforces the difficulty in comparison of prior studies that used different measurement scales. However, the 4 factors that were associated with fatigue measured by at least 2 of the scales in our study (unemployment, baseline antidepressant medication use, number of medical comorbidities, and lower hemoglobin) have also been previously identified in CKD-D samples [4,8,9,27,[29][30][31]. It is unclear whether unemployment begets fatigue or whether fatigue leads to an inability to work.…”

Section: Discussionmentioning

confidence: 48%

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: Discussionmentioning

confidence: 48%

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

et al. 2019

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“…[71]HDFACIT-FHADS-DHADS-APSQI (43) Wang et al . [72]HDFACIT-FPSQI (44) Williams et al . [73]HDVAS-FHADS-DHADS-A

HD, haemodialysis; PD, peritoneal dialysis; Tx, transplant; CAPD, continuous ambulatory peritoneal dialysis; CES-D, Center for Epidemiological Studies Depression; BDI, Beck Depression Inventory; HARS, Hamilton Anxiety Rating Scale; GDS, Geriatric Depression Scale; VAS-F, fatigue visual analogue scale; SDS, Self-Rating Depression Scale; MFI-20: Multi-dimensional Fatigue Inventory; HADS, Hospital Anxiety and Depression Scale; PSQI, Pittsburgh Sleep Quality Index; CFQ, Chalder Fatigue Questionnaire; SCL-90 R, Symptom Checklist-90-Revised; PDF, post-dialysis fatigue; HDRS, Hamilton Depression Rating Scale; STAI, State-Trait Anxiety Inventory; CIS, Checklist Individual Strength; BDI-PC, Beck Depression Inventory–Primary Care; FACIT-F, Functional Assessment of Chronic Illness Therapy-Fatigue; PHQ-9, The Patient Health Questionnaire; FSS, Fatigue Severity Scale; PFS, Piper Fatigue Scale; DASS 21, Depression Anxiety Stress Scale; KDQoL, The Kidney Disease Quality of Life Questionnaire; FSI, Fatigue Symptom Inventory; BFI, Brief Fatigue Inventory; SIP, Sickness Impact Profile 8.

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Section: Methodsmentioning

confidence: 99%

The role of psychological factors in fatigue among end-stage kidney disease patients: a critical review

et al. 2016

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Fatigue is a common and debilitating symptom, affecting 42–89% of end-stage kidney disease patients, persisting even in pre–dialysis care and stable kidney transplantation, with huge repercussions on functioning, quality of life and patient outcomes. This paper presents a critical review of current evidence for the role of psychological factors in renal fatigue. To date, research has concentrated primarily on the contribution of depression, anxiety and subjective sleep quality to the experience of fatigue. These factors display consistent and strong associations with fatigue, above and beyond the role of demographic and clinical factors. Considerably less research is available on other psychological factors, such as social support, stress, self-efficacy, illness and fatigue-specific beliefs and behaviours, and among transplant recipients and patients in pre-dialysis care. Promising evidence is available on the contribution of illness beliefs and behaviours to the experience of fatigue and there is some indication that these factors may vary according to treatment modality, reflecting the differential burdens and coping necessities associated with each treatment modality. However, the use of generic fatigue scales casts doubt on what specifically is being measured among dialysis patients, illness-related fatigue or post-dialysis-specific fatigue. Therefore, it is important to corroborate the available evidence and further explore, qualitatively and quantitatively, the differences in fatigues and fatigue-specific beliefs and behaviours according to renal replacement therapy, to ensure that any model and subsequent intervention is relevant and grounded in the experiences of patients.

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“…The Mental Component Summary scale (MCS) from the 12-item short-form (SF-12; version 2) was used to assess the quality of life in UP patients before and after treatment [22]. The scores for quality of sleep ranged from 0 to 21, and higher scores suggested worse quality of sleep (PSQI).…”

Section: Evaluation Of Quality Of Lifementioning

confidence: 99%

Comparison of high-flux hemodialysis with hemodialysis filtration in treatment of uraemic pruritus: a randomized controlled trial

Jiang

Chen

et al. 2016

Int Urol Nephrol

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Factors related to fatigue in Chinese patients with end-stage renal disease receiving maintenance hemodialysis: a multi-center cross-sectional study

Cited by 45 publications

References 48 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

The role of psychological factors in fatigue among end-stage kidney disease patients: a critical review

Comparison of high-flux hemodialysis with hemodialysis filtration in treatment of uraemic pruritus: a randomized controlled trial

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