BACKGROUND AND OBJECTIVES: Despite potential significance of fatigue and its underlying components in the occurrence of cardiovascular diseases, epidemiologic data showing the link are virtually limited. This study was designed to examine whether fatigue symptoms or fatigue's underlying components are a predictor for cardiovascular diseases in high-risk subjects with ESRD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: 788 volunteer patients under hemodialysis therapy (506 male, 282 female) completed the survey between October and November 2005, with the follow-up period up to 26 months to monitor occurrence of fatal or nonfatal cardiovascular events. The questionnaire consisted of 64 questions, and promax rotation analysis of the principal component method conceptualized eight fatigue-related factors: fatigue itself, anxiety and depression, loss of attention and memory, pain, overwork, autonomic imbalance, sleep problems, and infection. RESULTS: 14.7% of the patients showed fatigue scores higher than twice the SD of the mean for healthy volunteers. These highly fatigued patients exhibited a significantly higher risk for cardiovascular events (hazard ratio: 2.17; P < 0.01), with the relationship independent of the well-known risk factors, including age, diabetes, cardiovascular disease history, and inflammation and malnutrition markers. Moreover, comparisons of the risk in key subgroups showed that the risk of high fatigue score for cardiovascular events was more prominent in well-nourished patients, including lower age, absence of past cardiovascular diseases, higher serum albumin, and high non-HDL cholesterol. CONCLUSIONS: Fatigue can be an important predictor for cardiovascular events in patients with ESRD, with the relationship independent of the nutritional or inflammatory status.
BACKGROUND AND OBJECTIVES: Despite potential significance of fatigue and its underlying components in the occurrence of cardiovascular diseases, epidemiologic data showing the link are virtually limited. This study was designed to examine whether fatigue symptoms or fatigue's underlying components are a predictor for cardiovascular diseases in high-risk subjects with ESRD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: 788 volunteer patients under hemodialysis therapy (506 male, 282 female) completed the survey between October and November 2005, with the follow-up period up to 26 months to monitor occurrence of fatal or nonfatal cardiovascular events. The questionnaire consisted of 64 questions, and promax rotation analysis of the principal component method conceptualized eight fatigue-related factors: fatigue itself, anxiety and depression, loss of attention and memory, pain, overwork, autonomic imbalance, sleep problems, and infection. RESULTS: 14.7% of the patients showed fatigue scores higher than twice the SD of the mean for healthy volunteers. These highly fatigued patients exhibited a significantly higher risk for cardiovascular events (hazard ratio: 2.17; P < 0.01), with the relationship independent of the well-known risk factors, including age, diabetes, cardiovascular disease history, and inflammation and malnutrition markers. Moreover, comparisons of the risk in key subgroups showed that the risk of high fatigue score for cardiovascular events was more prominent in well-nourished patients, including lower age, absence of past cardiovascular diseases, higher serum albumin, and high non-HDL cholesterol. CONCLUSIONS:Fatigue can be an important predictor for cardiovascular events in patients with ESRD, with the relationship independent of the nutritional or inflammatory status.
Authors: J Green; S Fukuhara; T Shinzato; Y Miura; S Wada; R D Hays; R Tabata; H Otsuka; I Takai; K Maeda; K Kurokawa Journal: Qual Life Res Date: 2001 Impact factor: 4.147
Authors: Antonio Alberto Lopes; Jennifer L Bragg-Gresham; Sudtida Satayathum; Keith McCullough; Trinh Pifer; David A Goodkin; Donna L Mapes; Eric W Young; Robert A Wolfe; Philip J Held; Friedrich K Port Journal: Am J Kidney Dis Date: 2003-03 Impact factor: 8.860
Authors: Donna L Mapes; Antonio Alberto Lopes; Sudtida Satayathum; Keith P McCullough; David A Goodkin; Francesco Locatelli; Shunichi Fukuhara; Eric W Young; Kiyoshi Kurokawa; Akira Saito; Jürgen Bommer; Robert A Wolfe; Philip J Held; Friedrich K Port Journal: Kidney Int Date: 2003-07 Impact factor: 10.612
Authors: Mark Unruh; Robert Benz; Tom Greene; Guofen Yan; Srinivasan Beddhu; Maria DeVita; Johanna T Dwyer; Paul L Kimmel; John W Kusek; Alice Martin; Josephine Rehm-McGillicuddy; Brendan P Teehan; Klemens B Meyer Journal: Kidney Int Date: 2004-07 Impact factor: 10.612
Authors: Mark J Sarnak; Andrew S Levey; Anton C Schoolwerth; Josef Coresh; Bruce Culleton; L Lee Hamm; Peter A McCullough; Bertram L Kasiske; Ellie Kelepouris; Michael J Klag; Patrick Parfrey; Marc Pfeffer; Leopoldo Raij; David J Spinosa; Peter W Wilson Journal: Circulation Date: 2003-10-28 Impact factor: 29.690
Authors: Christine Horvat Davey; Allison R Webel; Ashwini R Sehgal; Joachim G Voss; Anne Huml Journal: Nephrol Nurs J Date: 2019 Sep-Oct Impact factor: 0.959
Authors: L Parker Gregg; Nishank Jain; Thomas Carmody; Abu T Minhajuddin; A John Rush; Madhukar H Trivedi; S Susan Hedayati Journal: Am J Nephrol Date: 2019-06-05 Impact factor: 3.754
Authors: Manisha Jhamb; Francis Pike; Sarah Ramer; Christos Argyropoulos; Jennifer Steel; Mary Amanda Dew; Steven D Weisbord; Lisa Weissfeld; Mark Unruh Journal: Am J Nephrol Date: 2011-05-09 Impact factor: 3.754
Authors: Ruth F Dubin; John R Teerlink; Nelson B Schiller; Dean Alokozai; Carmen A Peralta; Kirsten L Johansen Journal: Nephrol Dial Transplant Date: 2013-06-05 Impact factor: 5.992
Authors: Angela Ju; Armando Teixeira-Pinto; Allison Tong; Alice C Smith; Mark Unruh; Sara N Davison; Juan Dapueto; Mary Amanda Dew; Richard Fluck; Michael J Germain; Sarbjit V Jassal; Gregorio T Obrador; Donal O'Donoghue; Andrea K Viecelli; Giovanni Strippoli; Marinella Ruospo; Delia Timofte; Ankit Sharma; Eric Au; Martin Howell; Daniel S J Costa; Samaya Anumudu; Jonathan C Craig; Claudia Rutherford Journal: Clin J Am Soc Nephrol Date: 2020-10-22 Impact factor: 8.237