Prevalence and Severity of Postdialysis Fatigue Are Higher in Patients on Chronic Hemodialysis With Functional Disability

Bossola, Maurizio; Stasio, Enrico Di; Sirolli, Vittorio; Ippoliti, Fabio; Cenerelli, Stefano; Monteburini, Tania; Parodi, E; Santarelli, Stefano; Nebiolo, Pier Eugenio; Bonomini, Mario; Picca, Anna; Calvani, Riccardo; Marzetti, Emanuele

doi:10.1111/1744-9987.12705

Cited by 24 publications

(22 citation statements)

References 37 publications

(48 reference statements)

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“…Also, we observed that the Sum Score was negatively associated with ADL and IADL. This finding confirms the result of a previous study that demonstrated that prevalence and severity of PDF were higher in patients on chronic haemodialysis with functional disability (Bossola et al 2018b). Finally, we found that height was associated with reduced PDF intensity and PDF frequency.…”

Section: Discussionsupporting

confidence: 92%

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

Bossola

Stasio

Monteburini³

et al. 2020

Journal of Renal Care

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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

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Section: Discussionsupporting

confidence: 92%

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

Bossola

Stasio

Monteburini³

et al. 2020

Journal of Renal Care

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“…In a study of 271 Italian adults receiving maintenance dialysis, persons with ADL difficulties required an additional 94 minutes of recovery time. 30 In the Dialysis Outcomes and Practice Patterns Study, 31 recovery time was proportional to the degree of ADL difficulties. This picture suggests that for older adults receiving HD, mobility may need to be conceptualized as a condition that varies throughout the day.…”

Section: Discussionmentioning

confidence: 99%

Mobility in Older Adults Receiving Maintenance Hemodialysis: A Qualitative Study

Liu

Seo

Lee

et al. 2022

American Journal of Kidney Diseases

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“…With the improvement of dialysis technologies and medical devices, the survival duration of patients on hemodialysis (HD) has been significantly extended [1]. However, the health-related quality of life of HD patients is lower than that of the general population or of patients who undergo kidney transplantation [2,3].…”

Section: Introductionmentioning

confidence: 99%

Higher Postdialysis Lactic Acid Is Associated with Postdialysis Fatigue in Maintenance of Hemodialysis Patients

Yuan¹,

Lu²,

Qian³

et al. 2020

Blood Purif

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Background: Postdialysis fatigue (PDF) is not an unusual symptom among hemodialysis (HD) patients; however, its causes remain unclear. The aim of this study was to analyze the factors responsible for PDF in maintenance HD patients. Methods: This was a single-center cross-sectional study conducted between March 2018 and March 2019 at the Department of Blood Purification, Beijing Chao-Yang Hospital, Capital Medical University. One hundred and fifteen HD patients were enrolled. Clinical data on demographics, comorbidities, and the primary cause of end-stage renal disease were obtained by questionnaires. Laboratory data were collected pre-and post-HD. Participants were divided into 3 groups according to PDF degree. Results: The prevalence of PDF in participants was 60% (n = 69); 26.09% had mild PDF; and 33.91% had severe PDF. In the severe PDF group, the prevalence of intradialytic hypotension (IDH) was 38.46%, significantly higher than in the no PDF group (no-PDF; 8.70%) and mild-PDF (16.67%; p = 0.01 for both) groups. In the severe-PDF group, Charlson comorbidity index score and ultrafiltration rate were significantly higher than those in the no-PDF group (p = 0.040, p = 0.020, respectively). In the severe-PDF group, postdialysis lactic acid (Lac) level was significantly higher than that in the no-PDF or mild-PDF groups (p = 0.013 for both). And in the severe-PDF group, postdialysis sodium (Na) was significantly lower than that in the no-PDF or mild-PDF groups (p = 0.026 for both). It was shown by unconditional logistic regression analysis that IDH occurrence (OR 3.821, 95% CI 1.330-10.975), ultrafiltration rates (OR 1.142, 95% CI 1.018-1.281), lower postdialysis Na level (OR 0.724, 95% CI 0.556-0.942), and higher postdialysis Lac level (OR 2.465, 95% CI 1.126-5.397) were associated with PDF (p = 0.013, p = 0.024, p = 0.016, and p = 0.024, respectively). Conclusions: The prevalence of PDF was high among our study participants. PDF incidence was correlated with the IDH occurrence and higher postdialysis Lac and lower postdialysis Na levels. The level of Lac was a significant influencing factor for the fatigue of patients. More attention should thus be paid to PDF.

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Prevalence and Severity of Postdialysis Fatigue Are Higher in Patients on Chronic Hemodialysis With Functional Disability

Cited by 24 publications

References 37 publications

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

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

Mobility in Older Adults Receiving Maintenance Hemodialysis: A Qualitative Study

Higher Postdialysis Lactic Acid Is Associated with Postdialysis Fatigue in Maintenance of Hemodialysis Patients

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