Abstract
Fatigue is still present in up to 40–50% of kidney transplant recipients (KTR), the results of studies comparing the prevalence among patients on hemodialysis (HD) and KTR led to conflicting results. Fatigue correlates include inflammation, symptoms of depression, sleep disorders and obesity. Fatigue in KTR leads to significant functional impairment, it is common among KTR poorly adherent to immunosuppressive therapy and is associated with a serious deterioration of quality of life. The following databases were searched for relevant studies up to November 2020: Medline, PubMed, Web of Science and the Cochrane Library. Several studies have compared the prevalence and severity of fatigue between KTR and hemodialysis or healthy patients. They have shown that fatigue determines a significant functional deterioration with less chance of having a paid job and a significant change in quality of life. The aim of the review is to report methods to assess fatigue and its prevalence in KTR patients, compared to HD subjects and define the effects of fatigue on health status and daily life. There is no evidence of studies on the treatment of this symptom in KTR. Efforts to identify and treat fatigue should be a priority to improve the quality of life of KTR.
Highlights
Fatigue is a complex phenomenon that involves many aspects of existence and is determined by physical, psychological and emotional components
The aim of the present review is to report the methods to assess fatigue in kidney transplant recipients (KTR), the prevalence of fatigue in KTR in comparison with healthy individuals and hemodialysis patients, to define the effects of fatigue on the health status and on the daily living, in order to summarize the demographic, clinical and laboratory variables associated with its presence, indicating possible therapeutic strategies
A randomized controlled trial has shown that plantar reflexology significantly improved fatigue after kidney transplantation compared to controls [49]
Summary
Fatigue is a complex phenomenon that involves many aspects of existence and is determined by physical, psychological and emotional components. Health professionals may use terms such as asthenia, fatigue, lassitude, prostration, exercise intolerance, lack of energy and weakness to describe fatigue [1,2]. A recent meta-analysis has shown that the difference in health-related quality of life measured by the SF-36 instrument between KTR and hemodialysis patients was significantly reduced after controlling for age and diabetes [7]. After kidney transplantation, many patients still face the debilitating and prostrating symptom of fatigue [9,10]. This symptom is often underestimated as demonstrated by the observation that among the 63 KTR patients (out of 106) experiencing fatigue, only 8 (13%) had complaints of fatigue documented in medical records [9]
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