Intensity, Duration, and Frequency of Post‐Dialysis Fatigue in Patients on Chronic Haemodialysis

Abstract

Bossola M., Di Stasio E., Monteburini T., et al. (2020). Intensity, duration, and frequency of post-dialysis fatigue in patients on chronic haemodialysis. Journal of Renal Care 46(2), 115-123. S U M M A R YBackground: Although frequent and debilitating, little is known about the characteristics of post-dialysis fatigue (PDF). Objective: To characterise the intensity, duration and frequency of PDF and the associated variables in patients on chronic haemodialyses. Design: Prospective, observational and multicenter study. Patients: We studied 271 patients. Measurements: Patients were considered to be suffering from PDF if they spontaneously offered this complaint when asked the open-ended question: "Do you feel fatigued after dialysis? Then, each patient was invited to rate the intensity, duration and frequency of PDF from 1 to 5. Results: One hundred sixty-four patients (60.5%) had PDF. The median [95% confidence interval (CI)] scores of PDF intensity, duration and frequency were 3 (3-4), 3 (3-4) and 4 (4-4), respectively. The median (95% CI) of the sum of the scores (Sum Score) of PDF intensity, duration and frequency was 11 (10-12). Seventy four patients had a Sum Score ≥ 12. Using multiple regression analysis, PDF intensity was associated with dialytic age and ultrafiltration rate (UFR), PDF duration with dialytic age, while PDF fatigue frequency was associated with height. The Sum Score was associated with dialytic age and recovery time and negatively associated with daily activity, height and UFR (ml/kg/h). Conclusion: The intensity, duration and frequency of PDF are high in a large percentage of patients, suggesting that PDF is an intense event in terms of quantity and quality. Understanding the relationship between the variables associated with PDF and its intensity, duration and frequency may help better understand the underlying mechanisms of this burdensome condition. K E Y W O R D S Haemodialyses⦁ Fatigue ⦁ Post-dialysis ⦁ Recovery time ⦁ Ultrafiltration rate

The reliability and validity of the Turkish version of the postdialysis fatigue scale

“…A literature survey showed that measurement tools commonly used to evaluate the symptoms of dialysis patients did not include items on chest discomfort or dental pain 32 . We also did not come across data on symptoms related to chest discomfort or dental pain in any study evaluating PDF in patients with dialysis 1,6,8 . Item 9 and Item 10 were, therefore, removed from the scale and the PDF Scale consisting of 11 items afterwards was found to be reliable.…”

“…9 Although postdialysis recovery time is not the same as PDF, some studies have used it as an indirect measurement method for PDF. 1,6,8,35 The recovery time is defined as the time required to recover from the feelings of lassitude and fatigue. 1,15 The measurement performed after fixing the effect of age and gender by Kodama et al, 9 the developers of the original scale, has shown a statistically significant relationship between the scale scores and the postdialysis recovery time.…”

“…4 Jhamb et al 5 have used the postdialysis fatigue (PDF) term for the fatigue encountered after dialysis treatment, and it constitutes the most common symptom of these patients. 1,6 The condition requires over 5 hours of rest after the session for recovery in some dialysis patients, 2 thus creating significant additional time demands. The reported incidence is 50%-85%, [6][7][8] and it can be severe in 20% of these patients.…”

“…1,6 The condition requires over 5 hours of rest after the session for recovery in some dialysis patients, 2 thus creating significant additional time demands. The reported incidence is 50%-85%, [6][7][8] and it can be severe in 20% of these patients. 7 The mechanism is not fully understood, but various theories are present.…”

Correlation between Physical Activity and Psychological Distress in Patients Receiving Hemodialysis with Comorbidities: A Cross-Sectional Study

“…Patients who are older, women, have a longer disease duration, have cognitive disabilities, and were apathetic, anxious, and depressed experience higher levels of fatigue [ 60 ]. Moreover, hemodialysis duration is significantly correlated with anxiety, depression, and fatigue [ 31 , 61 ]. Additionally, studies have revealed that marital status, having a fixed income, having chronic diseases, and lack of physical activity are correlated with depression in patients on hemodialysis [ 47 ].…”