#2824 Use of proton pump inhibitors is not associated with post-dialysis fatigue and time of recovery after dialysis in patients on chronic hemodialysis

Abstract

Abstract Background and Aims Chronic hemodialysis is often associated with post-dialysis fatigue (PDF), a condition characterized by extreme tiredness and lack of energy. PDF is a debilitating symptom that significantly impairs quality of life of hemodialysis patients. Furthermore, PDF is independently associated with the time to recover after dialysis (TIRD), which can be used as an indirect measure of PDF. Recent studies have shown that the use of proton pump inhibitors (PPI) is independently associated with the prevalence and severity of fatigue in kidney transplant recipients. The aim of this study is to determine whether the use of PPIs in patients undergoing chronic hemodialysis is associated with PDF prevalence and characteristics, as well as the TIRD. Method For this retrospective study, we recruited patients undergoing chronic hemodialysis and asked open-ended questions about their post-dialysis fatigue and time of recovery. Each patient was asked to rate the intensity, duration and frequency of their PDF on a scale of 1 to 5. We defined whether patients used a PPI (no PPI use or PPI use), the type of PPI used, the dose of PPI used, and the duration of the PPI use (<1 year or ≥1year). Results The study analysed 346 patients, of whom 259 used PPIs (55 used omeprazole, 63 esomeprazole, 54 pantoprazole, 87 lansoprazole, and 7 rabeprazole) and 87 did not. Among the patients, 232 reported suffering from PDF, while 114 did not. The median [min-max] TIRD was 210 minutes [0-1440]. The prevalence of PDF in PPI users and non-users was 67% and 68%, respectively (p= 0.878). There was no significant difference in the median [min-max] TIRD between PPI users and non-users (180 [0-1440] and 240 [0-1440], respectively; p=0.871). Additionally, there was no significant difference in the median PDF intensity, duration, frequency, and severity PPI users and non-users. The prevalence of PDF was similar among the different types of PPI used and did not differ with respect to PPI non-users. Duration of PPI exposure was <1 year in 42 patients and ≥1 year in 224 patients. There was no difference in prevalence of PDF between the two exposures. The correlation matrix showed no statistical significance between PPI equivalent dose, treatment duration, PDF frequency, PDF characteristics, and TIRD. Conclusion There is no association between the use of PPIs and PDF or time of recovery after dialysis in patients on chronic hemodialysis.