Patterns and predictors of fatigue following living donor nephrectomy: Findings from the KDOC Study.

Abstract

This study sought to identify the prevalence, pattern, and predictors of clinical fatigue in 193 living kidney donors (LKDs) and 20 healthy controls (HCs) assessed at predonation and 1, 6, 12, and 24monthspostdonation. Relative to HCs, LKDs had significantly higher fatigue severity (P=.01), interference (P=.03), frequency (P=.002), and intensity (P=.01), and lower vitality (P<.001), at 1-month postdonation. Using published criteria, significantly more LKDs experienced clinical fatigue at 1 monthpostdonation, compared to HCs, on both the Fatigue Symptom Inventory (60% vs. 37%, P<.001) and SF-36 Vitality scale (67% vs. 16%, P<.001). No differences in fatigue scores or clinical prevalence were observed at other time points. Nearly half (47%) reported persistent clinical fatigue from 1 to 6months postdonation. Multivariable analyses demonstrated that LKDs presenting for evaluation with a history of affective disorder and low vitality, those with clinical mood disturbance and anxiety about future kidney failure after donation, and those with less physical activity engagement were at highest risk for persistent clinical fatigue 6monthspostdonation. Findings confirm inclusion of fatigue risk in existing OPTN informed consent requirements, have important clinical implications in the care of LKDs, and underscore the need for further scientific examination in this population.