Fatigue in kidney transplant recipients

Bossola, Maurizio; Pepe, Gilda; Vulpio, Carlo

doi:10.1111/ctr.12846

Cited by 24 publications

(19 citation statements)

References 62 publications

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“…In spite of the relatively small size of the groups, the KDQOL-36 subscales were significantly or near significantly different between most of the groups formed by clinical variables, confirming that the differences between these groups were large enough to be captured by sensitive enough tools. As expected, individual ESAS-r physical item scores and the Physical Symptom Score were different between the groups based on clinical characteristics [109].…”

Section: Discussionsupporting

confidence: 75%

Evaluating symptom burden in kidney transplant recipients: validation of the revised Edmonton Symptom Assessment System for kidney transplant recipients – a single‐center, cross‐sectional study

et al. 2020

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Summary We assessed the validity of the Edmonton Symptom Assessment System (ESAS‐r) in kidney transplant recipients (KTR). A cross‐sectional sample of 252 KTR was recruited. Individual ESAS‐r symptom scores and symptom domain scores were evaluated. Internal consistency, convergent validity, and construct validity were assessed with Cronbach’s α, Spearman’s rank correlations, and a priori‐defined risk group comparisons. Mean (SD) age was 51 (16), 58% were male, and 58% Caucasian. ESAS‐r Physical, Emotional, and Global Symptom Scores demonstrated good internal consistency (α > 0.8 for all). ESAS‐r Physical and Global Symptom Scores strongly correlated with PHQ‐9 scores (0.72, 95% CI: 0.64–0.78 and 0.74, 95% CI: 0.67–0.80). For a priori‐defined risk groups, individual ESAS‐r symptom score differed between groups with lower versus higher eGFR [pain: 1 (0–3) vs. 0 (0–2), delta = 0.18; tiredness: 3 (1–5) vs. 1.5 (0–4), delta = 0.21] and lower versus higher hemoglobin [tiredness: 3 (1–6) vs. 2 (0–4), delta = 0.27]. ESAS‐r Global and Physical Symptom Scores differed between groups with lower versus higher hemoglobin [13 (6–29) vs. 6.5 (0–18.5), delta = 0.3, and 9 (2–19) vs. 4 (0–13), delta = 0.24] and lower versus higher eGFR [11 (4–20) vs. 6.5 (2–13), delta = 0.21, and 7 (2–16) vs. 3 (0–9), delta = 0.26]. These data support reliability and construct validity of ESAS‐r in KTR. Future studies should explore its clinical utility for symptom assessment among KTR.

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Section: Discussionsupporting

confidence: 75%

Evaluating symptom burden in kidney transplant recipients: validation of the revised Edmonton Symptom Assessment System for kidney transplant recipients – a single‐center, cross‐sectional study

et al. 2020

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“…One hypothesis to explain these connections is that fatigue (reported prevalence post-kidney transplantation: 40%-50% [ 31 ]) interferes with perceived sleep quality. It also limits a person's ability to carry out ordinary daily activities, with a bidirectional impact on sleep [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Change of sleep quality from pre- to 3 years post-solid organ transplantation: The Swiss Transplant Cohort Study

et al. 2017

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BackgroundPoor sleep quality (SQ) is common after solid organ transplantation; however, very little is known about its natural history. We assessed the changes in SQ from pre- to 3 years post-transplant in adult heart, kidney, liver and lung recipients included in the prospective nation-wide Swiss Transplant Cohort Study. We explored associations with selected variables in patients suffering persistent poor SQ compared to those with good or variable SQ.MethodsAdult single organ transplant recipients enrolled in the Swiss Transplant Cohort Study with pre-transplant and at least 3 post-transplant SQ assessment data were included. SQ was self-reported pre-transplant (at listing), then at 6, 12, 24 and 36 months post-transplant. A single SQ item was used to identify poor (0–5) and good sleepers (6–10). Between organ groups, SQ was compared via logistic regression analysis with generalized estimating equations. Within the group reporting persistently poor SQ, we used logistic regression or Kaplan-Meier analysis as appropriate to check for differences in global quality of life and survival.ResultsIn a sample of 1173 transplant patients (age: 52.1±13.2 years; 65% males; 66% kidney, 17% liver, 10% lung, 7% heart) transplanted between 2008 and 2012, pre- transplant poor SQ was highest in liver (50%) and heart (49%) recipients. Overall, poor SQ decreased significantly from pre-transplant (38%) to 24 months post-transplant (26%) and remained stable at 3 years (29%). Patients reporting persistently poor SQ had significantly more depressive symptomatology and lower global quality of life.ConclusionBecause self-reported poor SQ is related to poorer global quality of life, these results emphasize the need for further studies to find suitable treatment options for poor SQ in transplant recipients.

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“…Kidney transplantation is considered the best treatment for end-stage kidney disease (ESKD) by offering better long-term outcomes and quality of life (QoL) compared with dialysis treatment [1][2][3]. However, health-related QoL of kidney transplant recipients (KTR) is still lower than the general population and fatigue is an important contributor to this impaired QoL of KTR [4][5][6][7]. Reducing symptoms and complications of treatment, such as fatigue, as well as coping with its consequences for everyday life belongs to patients' research priorities [8].…”

Section: Introductionmentioning

confidence: 99%

Protein Intake, Fatigue and Quality of Life in Stable Outpatient Kidney Transplant Recipients

et al. 2020

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Fatigue is a frequent complaint in kidney transplant recipients (KTR), often accompanied by poor quality of life (QoL). The role of nutrition as determinant of fatigue in KTR is largely unexplored. The aims of this study are to examine the association of protein intake with fatigue and QoL in KTR and to identify other determinants of fatigue. This cross-sectional study is part of the TransplantLines Cohort and Biobank Study (NCT03272841). Protein intake was calculated from urinary urea nitrogen (UUN) in 24-h urine samples. Fatigue was assessed by the Checklist Individual Strength (CIS) questionnaire; moderate and severe fatigue were defined as a CIS score of 20–34 and ≥ 35, respectively. QoL was assessed with the RAND-36-Item Health Survey (RAND-36). Associations of protein intake with fatigue and QoL were analyzed using multinomial logistic and linear regression analyses. We included 730 stable outpatient KTR (median age 58 year [IQR 48–65], 57% male) with a mean protein intake of 82.2 ± 21.3 g/d. Moderate and severe fatigue were present in 254 (35%) and 245 (34%) of KTR. Higher protein intake was significantly associated with lower risk of moderate fatigue (OR 0.89 per 10 g/d; 95%CI 0.83–0.98, p = 0.01), severe fatigue (OR 0.85; 95%CI 0.78–0.92, p < 0.001) and was associated with higher physical component summary score of QoL (β 0.74 per 10 g/d; 95%CI 0.39–1.09, p < 0.001). Higher BMI, a history of dialysis, glomerulonephritis as primary kidney disease and a history of combined organ transplantation were also associated with severe fatigue. In conclusion, amongst the potential modifiable factors of fatigue, higher protein intake is independently associated with lower risk of moderate and severe fatigue and with better QoL in KTR. These findings underline the need to incorporate nutritional assessment in the diagnostic work-up of fatigue. Intervention studies are needed to assess the benefits and safety of higher protein intake in KTR.

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Fatigue in kidney transplant recipients

Cited by 24 publications

References 62 publications

Evaluating symptom burden in kidney transplant recipients: validation of the revised Edmonton Symptom Assessment System for kidney transplant recipients – a single‐center, cross‐sectional study

Evaluating symptom burden in kidney transplant recipients: validation of the revised Edmonton Symptom Assessment System for kidney transplant recipients – a single‐center, cross‐sectional study

Change of sleep quality from pre- to 3 years post-solid organ transplantation: The Swiss Transplant Cohort Study

Protein Intake, Fatigue and Quality of Life in Stable Outpatient Kidney Transplant Recipients

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