Patient-reported intra-dialytic symptoms and post-dialysis recovery times are influenced by psychological distress rather than dialysis prescription

Yoowannakul, Suree; Tangvoraphonkchai, Kamonwan; Davenport, Andrew

doi:10.1186/s41100-019-0211-1

Cited by 9 publications

(13 citation statements)

References 37 publications

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“…A prolonged recovery time affects both the patients and the healthcare professionals or caregivers. Thus, determining the modifiable treatment-related factors has received increasing attention [5][6][7][8][9][10][11][12][13]. In our country, there are not any previous studies on this particular matter.…”

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confidence: 99%

Do biochemical parameters and intradialytic symptoms affectpost‐dialysisrecovery time? A prospective, descriptive study

Özen

Cepken²,

Tosun

2021

Ther Apher Dial

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The recovery time is defined as the time required to recover from the feelings of lassitude and fatigue. The daily activities of patients are affected by dialysis sessions, requiring significant time for patients to return to their routines. This situation implies a lower quality of life for HD patients. The aim of this study was to investigate the effects of biochemical parameters and intradialytic symptoms on post-dialysis recovery time in maintenance HD patients. This study was conducted at a private dialysis center during June and August 2019. Data were collected using the "Descriptive Characteristics Form" and the "Dialysis Symptom Index." "STROBE check-list" was used for the report of the study. The study was completed with 86 participants. The median post-dialysis recovery time was 240 min (interquartile range, 120-360 min), and female patients exhibit significantly higher recovery time than male patients. The median BMI was statistically significantly higher in patients whose post-dialysis recovery time was ≥240 min. Additional findings show that the post-dialysis recovery time was shortened by 0.230 times for male patients, while intradialytic hypotension (IDH) prolonged the median post-dialysis recovery time by 3.141 times. Factors underlying the IDH should be determined in order to eradicate the issue. The study was registered in ClinicalTrials.gov with the number NCT04274556.body mass index, female gender, intradialytic hypotension, intradialytic symptoms, post-dialysis recovery time | INTRODUCTIONPatients undergoing HD can experience symptoms such as lassitude, pain, muscle cramps, nausea, vomiting, constipation, diarrhea, rash, skin dryness, sleep disorders, depression, anxiety, and emotional and sexual problems after the treatment [1,2]. Many chronic HD patients do not feel well after the treatment sessions and need some time to recover. This recovery time is defined as the time required to recover from the feelings of lassitude and fatigue. The daily routines and work life of the patients were negatively affected, so a significant amount of time is required to recover [3,4].The Dialysis Outcomes and Practice Study reported that the recovery time for patients under 2, 2-6, 7-12, and >12 h were 32%, 42%, 17% and 10% respectively [5].

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confidence: 99%

Do biochemical parameters and intradialytic symptoms affectpost‐dialysisrecovery time? A prospective, descriptive study

Özen

Cepken²,

Tosun

2021

Ther Apher Dial

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“…[ 17 ] had not found any significant association between recovery time and other variables. Another study done by Yoowannakul[ 23 ] et al . showed that younger patients had prolong recovery time than elderly patients.…”

Section: Discussionmentioning

confidence: 99%

“…Most of the studies gave conflicting results regarding the associated factors with DRT. [ 18 22 23 24 25 ] Multicentric studies including a larger sample size in Indian HD patients may be needed to find out the other significant variables that predict DRT.…”

Section: Discussionmentioning

confidence: 99%

A study of Factors Affecting Dialysis Recovery Time in Haemodialysis Patients in India

et al. 2021

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Background: Patients on maintenance haemodialysis (MHD) often complain of fatigue and tiredness following haemodialysis sessions leading to poor compliance with the dialysis schedule. There is limited Indian data on dialysis recovery time (DRT). The present study was designed to assess the factors affecting DRT in our haemodialysis population. Methods: We recorded self-reported patient recovery times of 120 patients who satisfied the inclusion criteria, over three consecutive dialysis sessions by asking the question, 'How long does it take to recover from a dialysis session'? Data recorded included patient factors like age, sex, co-morbidities, Charlson comorbidity index score (CCI), dialysis vintage, duration of kidney disease, interdialytic weight gain (IDWG), treatment factors like ultrafiltration rate (UFR), SpKt/V, blood pump speed, dialysate sodium, session length, pre and post HD blood pressure and laboratory parameters. Health-related quality of life (HRQoL) was assessed with the KDQOL-SF v. 1.3 questionnaire. Results from the SF-36 score were summarised into the physical composite score (PCS), mental composite score (MCS) and kidney disease composite score (KDCS). Results: The mean age of the study population was 50.6 ± 12.6 years. Among the 120 patients, 77 (64.2%) were males. Thirty-nine patients (32.5%) were diabetic and 95 (79.1%) patients were hypertensive. The mean dialysis vintage of the study population was 26.1 ± 18.6 months, 41 (34.2%) patients reported DRT <2 h; 48 (40%) reported DRT between 2–6 h and 31 (25.8%) reported DRT >6 h. On multivariate regression analysis, higher IDWG, CCI score and UFR were associated with prolonged DRT. Reported DRT also inversely correlated with PCS (r = - 0.66), MCS (r = - 0.65) and KDCS (r = - 0.59) scores which was statistically significant. Conclusion: The present study showed that higher CCI scores, IDWG and UFR were associated with prolonged DRT in Indian haemodialysis patients and patients with longer recovery time had poor HRQoL. Interventions to reduce DRT need to be assessed in further trials in Indian MHD patients.

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“…Patient-centered care in dialysis requires a multifaceted approach to better understand influential patient factors 5 and incorporation of patients’ perspectives routinely into structured care delivery. 6 Dialysis metrics have historically focused on urea kinetics, hospitalization rates and mortality, vascular access, other biochemical results such as serum calcium level, and infectious complications.…”

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“… 11 For instance, depression has been linked to an increase in symptom perception and reporting among the elderly. 13 Among dialysis patients, increased self-reported psychological distress is associated with greater dialysis-related symptom burden, 5 and higher self-reported depression scores are associated with increased dialysis recovery time. 7 The scale used by Alvarez et al would have been strengthened by the inclusion of a psychological assessment such as psychological distress, anxiety, or situational fear.…”

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confidence: 99%

Intradialytic Symptoms and Recovery Time: Thinking ‘Outside the Box’ to Improve Patients’ Dialysis Experience

Umeukeje

Cavanaugh

2020

Kidney Medicine

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I n this issue of Kidney Medicine, Alvarez et al, 1 using responses to a National Kidney Foundation scientific survey, present an informative and timely study detailing self-reported symptoms during in-center hemodialysis and associations between symptoms experienced during dialysis with recovery time after dialysis treatments. Dialysis recovery time is an important concept that encapsulates challenges experienced by dialysis patients contributing to impaired health-related quality of life. 2 Recovery time is measured by asking the reliable, valid, and responsive question, "How long does it take you to recover from a dialysis session?" 3 Using an online symptom questionnaire modified from the Kidney Disease Quality of Life Symptoms and Problems With Kidney Disease scale, 4 Alvarez et al queried patients' experiences of a range of symptoms, including fatigue, low blood pressure, cramps, headache, faintness or dizziness, itchy skin, nausea or upset stomach, vomiting, shortness of breath, irregular heart rate, chest pain, and difficulty concentrating during dialysis in the previous week. A total symptom score for each patient was derived from the product of the number and average severity of symptoms. In this crosssectional study, Alvarez et al asked about average dialysis recovery time during the previous week: "Over the last week, how long did it take you on average to recover from your dialysis sessions and resume your normal, usual activities?" They also asked about dialysis treatment nonadherence, including skipping and shortening of treatments.Of 10,000 patients sent the online questionnaire, only 464 (4.6%) responded, raising some questions about the generalizability of the results. Nevertheless, most (87%) patients reported burdensome symptoms during dialysis, including fatigue (67%), cramps (44%), and low blood pressure (42%). Median reported dialysis recovery time was 3 hours, and this moderately correlated with the incidence and severity of intradialytic symptoms (τ = 0.28: 90% CI, 0.26-0.38; P < 0.0001). A third of the patients credited intradialytic symptoms to shortening their dialysis treatments, and a minority (6%) of patients attributed missed dialysis sessions to their intradialytic symptoms.This important study builds on structured assessments of dialysis-related symptom burden and its implications for the experience and delivery of the dialysis procedure. It also contributes direct confirmatory testimony from

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Patient-reported intra-dialytic symptoms and post-dialysis recovery times are influenced by psychological distress rather than dialysis prescription

Cited by 9 publications

References 37 publications

Do biochemical parameters and intradialytic symptoms affectpost‐dialysisrecovery time? A prospective, descriptive study

Do biochemical parameters and intradialytic symptoms affectpost‐dialysisrecovery time? A prospective, descriptive study

A study of Factors Affecting Dialysis Recovery Time in Haemodialysis Patients in India

Intradialytic Symptoms and Recovery Time: Thinking ‘Outside the Box’ to Improve Patients’ Dialysis Experience

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