Subrata Debnath1, Rain Rueda2, Shweta Bansal3, Balakuntalam S Kasinath3, Kumar Sharma3, Carlos Lorenzo4. 1. Division of Nephrology, Department of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Dr, San Antonio, TX, USA. nath@uthscsa.edu. 2. University Health, 4502 Medical Dr, San Antonio, TX, USA. 3. Division of Nephrology, Department of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Dr, San Antonio, TX, USA. 4. Division of Clinical Immunology, Department of Medicine, University of Texas Health San Antonio, 7703 Floyd Curl Dr, San Antonio, TX, USA.
Abstract
BACKGROUND: Fatigue is prevalent in hemodialysis patients who for survival follow a strict dialysis treatment regimen - dialysis and non-dialysis days. As a result, the daily activities, symptom burden, and clinical outcomes of hemodialysis patients vary significantly between dialysis and non-dialysis days. Fatigue is one of the most reported debilitating symptoms by hemodialysis patients with profound negative impact on their quality of life. Prior studies assessed fatigue during the preceding 7 or 30 days and did not discriminate fatigue characteristics between dialysis and non-dialysis days. We aimed to characterize and compare fatigue severity and fatigue interference with daily activities between dialysis and non-dialysis days. METHODS: Hemodialysis patients self-reported fatigue on consecutive dialysis and non-dialysis days using the 9-item Brief Fatigue Inventory. The differences in fatigue characteristics between dialysis and non-dialysis days were analyzed using one-way ANCOVA. RESULTS: Global fatigue burden was worse on a dialysis day compared to a non-dialysis day (P for all < 0.001). Age and education were associated with fatigue, but hemodialysis-related variables were not. A significant inverse association of physical activity with fatigue severity observed on non-dialysis day; there was also a negative association between the normalized protein catabolic rate and fatigue severity on both dialysis and non-dialysis days. The positive association of depression with fatigue severity and fatigue interference were consistent on both dialysis and non-dialysis days. None of these factors, however, explained differences in fatigue characteristics between dialysis and non-dialysis days. CONCLUSIONS: Fatigue, measured in severity and interference, was more pronounced on a dialysis day relative to a non-dialysis day. These differences were not explained by age, sex, education, hemodialysis-related variables, habitual exercise, nutritional status, and or depression. The quantitative measures of fatigue characteristics may facilitate future interventional trials design and better fatigue management for hemodialysis patients.
BACKGROUND: Fatigue is prevalent in hemodialysis patients who for survival follow a strict dialysis treatment regimen - dialysis and non-dialysis days. As a result, the daily activities, symptom burden, and clinical outcomes of hemodialysis patients vary significantly between dialysis and non-dialysis days. Fatigue is one of the most reported debilitating symptoms by hemodialysis patients with profound negative impact on their quality of life. Prior studies assessed fatigue during the preceding 7 or 30 days and did not discriminate fatigue characteristics between dialysis and non-dialysis days. We aimed to characterize and compare fatigue severity and fatigue interference with daily activities between dialysis and non-dialysis days. METHODS: Hemodialysis patients self-reported fatigue on consecutive dialysis and non-dialysis days using the 9-item Brief Fatigue Inventory. The differences in fatigue characteristics between dialysis and non-dialysis days were analyzed using one-way ANCOVA. RESULTS: Global fatigue burden was worse on a dialysis day compared to a non-dialysis day (P for all < 0.001). Age and education were associated with fatigue, but hemodialysis-related variables were not. A significant inverse association of physical activity with fatigue severity observed on non-dialysis day; there was also a negative association between the normalized protein catabolic rate and fatigue severity on both dialysis and non-dialysis days. The positive association of depression with fatigue severity and fatigue interference were consistent on both dialysis and non-dialysis days. None of these factors, however, explained differences in fatigue characteristics between dialysis and non-dialysis days. CONCLUSIONS: Fatigue, measured in severity and interference, was more pronounced on a dialysis day relative to a non-dialysis day. These differences were not explained by age, sex, education, hemodialysis-related variables, habitual exercise, nutritional status, and or depression. The quantitative measures of fatigue characteristics may facilitate future interventional trials design and better fatigue management for hemodialysis patients.
Authors: Astrid D H Brys; Bert Lenaert; Caroline M Van Heugten; Giovanni Gambaro; Maurizio Bossola Journal: J Pain Symptom Manage Date: 2019-02-16 Impact factor: 3.612
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
Authors: Khaled Abdel-Kader; Manisha Jhamb; Lee Anne Mandich; Jonathan Yabes; Robert M Keene; Scott Beach; Daniel J Buysse; Mark L Unruh Journal: BMC Nephrol Date: 2014-02-06 Impact factor: 2.388
Authors: Aminu K Bello; Ikechi G Okpechi; Mohamed A Osman; Yeoungjee Cho; Htay Htay; Vivekanand Jha; Marina Wainstein; David W Johnson Journal: Nat Rev Nephrol Date: 2022-02-22 Impact factor: 42.439