Post-dialysis Fatigue Research Articles

Effect of different dialysate temperatures on post dialysis fatigue in patients undergoing haemodialysis: a quasi-experimental study.

To compare the effects of warm and cold dialysate solutions on the duration of post-dialysis fatigue in patients undergoing maintenance haemodialysis. The quasi-experimental study was conducted at the Department of Nephrology, Pak Emirates Military Hospital, Rawalpindi, Pakistan, from May 9 to September 10, 2023, and comprised adult patients of either gender undergoing maintenance haemodialysis for a minimum of 3 months. The patient initially underwent haemodialysis with a dialysate temperature of 36°C for 2 weeks. During the subsequent washout period of one week when the dialysate temperature was not monitored, they underwent haemodialysis with a dialysate temperature of 37°C for another 2 weeks. Blood pressure was monitored every 30 minutes to record any hypotensive episodes. Patients were asked if they felt fatigued after the last haemodialysis session, and the duration was noted down. Data was analysed using SPSS 24. Of the 92 patients with mean age 49.1±16.1 years, 57(62%) were males. Post-dialysis fatigue was seen in 67(72.8%) and 75(81.5%) patients with dialysate temperatures at 36°C and 37°C, respectively (p<0.001). The duration of post-dialysis fatigue was also significantly longer at dialysate temperatures 37°C p<0.001). There was no significant difference in the proportion of hypotensive episodes in the two groups (p=0.445). Dialysate temperature 36°C was found to be associated with less frequent and shorter duration of postdialysis fatigue compared to dialysate temperature 37°C.

Predictors of Fatigue Among Patients on Hemodialysis: An Observational Study.

Background Hemodialysis is a chronic replacement therapy recommended during end-stage renal disease (ESRD) in chronic kidney disease (CKD). Post-dialysis fatigue (PDF) is one of the symptoms patients experience after the treatment. This multifactorial condition is subjective and characterized by a lack of physical and emotional energy. It can be associated with other symptoms such as nausea, headache, muscle cramps, and hypotension. Currently, researchers have not been able to find defined etiologies and pathogenesis. This study aims to analyze the influence of PDF predictors within a sample of patients undergoing hemodialysis. Methodology A multicenter, observational study was conducted on a convenience sample of 250 CKD patients with ESRD on hemodialysis between February and July 2023. PDF was assessed using the Piper Fatigue Scale (PFS), administered in both paper and electronic formats. The data analysis was done using descriptive and inferential statistics and correlation tests. Results The analysis revealed that sleep disorders perceived (p = 0.0001; τ = 0.23), the presence of comorbidity (p = 0.003; τ = 0.18), the number of weekly sessions (p = 0.012; τ = 0.15), and the period of hemodialysis (p = 0.0069; τ = 0.15) had a positive correlation with the PFS score. The study highlighted that hemoglobin level (p = 0.017; τ = - 0.14) and sex (p = 0.012; τ = 0.15) affected the PDF perception. Patients who engaged in physical activities or used distraction techniques (p = 1.83e-05; τ = 0.26) to alleviate PDF reported lower average scores on the PFS (2.27 points) compared to those who did not engage in any such activities. Conclusions Hemodialysis appears to be a source of stress for most patients, as they showed a moderate-to-severe score on the PFS scale. PDF is a multifactorial problem that must be recognized and treated properly by nurses through pharmacological therapies, as well as by educating and providing alternative strategies, that can contribute to alleviating the effects of fatigue.

Post-dialysis fatigue predicts all-cause mortality in patients on chronic hemodialysis.

Fatigue is reportedly associated with a poor prognosis in dialysis patients. The aim of the present study was to investigate whether fatigue on dialysis days or non-dialysis days is associated with mortality in patients on chronic hemodialysis. This was a prospective study of 134 hemodialysis patients. The level of fatigue was evaluated using a visual analog scale (VAS). The association between high fatigue evaluated by the highest quartile of the VAS value and all-cause death was investigated. The fatigue scale score was significantly higher on dialysis than on non-dialysis days. During the follow-up period (median 6.8 years), 42 patients died. Patients with high post-dialysis fatigue in the higher quartiles died more frequently compared to those with in the lower quartiles (p = 0.012). Multivariate Cox regression analysis showed that high post-dialysis fatigue was an independent predictor of all-cause death (adjusted hazard ratio 2.12, 95% confidence interval 1.10-4.07). Higher post-dialysis fatigue is related to increased mortality.

Postdialysis Fatigue and Comfort Levels of Patients Receiving Hemodialysis Treatment

Postdialysis Fatigue and Comfort Levels of Patients Receiving Hemodialysis Treatment

Use of Proton Pump Inhibitors Is Not Associated with Post-Dialysis Fatigue and Time of Recovery after Dialysis in Patients on Maintenance Hemodialysis.

Objectives: To define if the use of proton pump inhibitors (PPI) is associated with PDF prevalence and characteristics and with time of recovery after dialysis in patients on maintenance hemodialysis. Methods: Patients were defined as experiencing PDF if they spontaneously offered this complaint when asked the open-ended question: "Do you feel fatigued after dialysis?". Time of recovery after dialysis (TIRD) was also assessed for each patient. Each patient was invited to rate the intensity, duration and frequency of PDF from 1 to 5. We defined if patients used PPI (no PPI use or PPI use), the type of used PPI, the dose of used PPI, and the duration of the use of PPI (<1 year or ≥1 year). Results: A total of 346 patients were studied: 259 used PPI (55 used omeprazole, 63 esomeprazole, 54 pantoprazole, 87 lansoprazole, and 7 rabeprazole) and 87 did not. Two hundred and thirty-two patients declared PDF and 114 did not. The median [min-max] TIRD was 210 min [0-1440]. The prevalence of PDF in PPI users and PPI non-users was 67% and 68%, respectively (p = 0.878). The median [min-max] TIRD did not differ significantly between PPI users and PPI non-users (180 [0-1440] and 240 [0-1440], respectively; p = 0.871). Median PDF intensity, duration, frequency, and severity did not differ significantly between PPI use and no use. The prevalence of PDF was similar among the different types of PPI use and did not differ with respect to PPI non-users. Duration of PPI exposure was <1 year in 40 patients and ≥1 year in 219 patients. The prevalence of PDF did not differ between the two exposures. The correlation matrix between PPI equivalent dose, PPI treatment duration and PDF frequency, PDF characteristics, and TIRD showed whether there was statistical significance. Conclusions: The use of PPI is not associated with PDF and time of recovery after dialysis in patients on maintenance hemodialysis.

#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 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 (&amp;lt;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 &amp;lt;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.

#2947 Exploring various approaches for assessing fatigue in patients receiving hemodialysis using the CONVINCE study population

Abstract Background and Aims In nephrology, there is a growing interest in identifying patients’ priorities to achieve meaningful outcomes. A particular relevant outcome in end stage kidney disease is fatigue, with prevalence ranging from 60% to 97% in patients receiving hemodialysis. Different approaches for assessing fatigue exist. The objective of this study was to investigate how self-reported peri-/intra-dialytic and post-dialysis fatigue relate to overall fatigue levels and to certain risk factors of patients receiving hemodialysis. Method The CONVINCE trial is an international multi-center, prospective, randomized, open label, controlled trial, comparing all-cause mortality of high-flux hemodialysis with high-dose hemodiafiltration. Patient-related outcomes (PROs) were examined as secondary outcomes. Fatigue was assessed using tailored short forms from the Patient-Reported Outcome Measurement Information System (PROMIS) to measure overall fatigue, the newly developed Convince Dialysis Fatigue Scale (CDFS) to capture peri-/intra-dialytic fatigue and the Convince Time to Recovery (CTTR-1) to measure post-dialysis fatigue. PROs were collected every 3 months for 24 months, except for CTTR-1 and a PROMIS fatigue short form, which were collected on a monthly basis from the 1st to 5th months. To investigate the agreement between overall fatigue, peri-/intra-dialytic and post-dialysis fatigue, Spearman's correlation was calculated. In addition, we examined whether general health, depression, physical function, sex and dialysis vintage were related to peri-/intra-dialytic, post-dialysis and overall fatigue in a cross-sectional study design (irrespective of dialysis modality). To test for change over time as well as differences between groups Cohen's d effect sizes were calculated. Results Data for PROs was collected from 1282 participants at baseline and 804 after 24 months. The PROMIS fatigue score and the CDFS correlated strongly at each measurement point (Spearman r≥0.67). The PROMIS fatigue score and CTTR-1 correlated moderately (Spearman r≥0.41). We found large effect sizes for mean differences for peri-/intra-dialytic fatigue between patients with/without at least mild depression (Cohen's d 1.27 (95%CI 1.11 to 1.44)) as well as between patients with/without at least moderately impaired physical function (Cohen's d 1.04 (95% CI 0.89 to 1.19)). Patients, who reported CTTR-1 ≥12 hours, showed also large effect sizes for mean differences for overall fatigue between patients with/without at least mild depression (Cohen's d 0.9 (95% CI 0.48 to1.39)) as well as between patients with/without at least moderately impaired physical function (Cohen's d of 1.1 (95% CI 0.7 to 1.67)). In almost half of the patients, the time to recovery was &amp;gt; 4 hours, and patients who reported having to recover for a longer time after dialysis were, on average, more fatigued overall. Overall fatigue, with an observed mean change of 2.10 (SD 9.69) of PROMIS fatigue score, and peri-/intra dialytic fatigue, with an observed mean change of 1.98 (SD 6.98) of CDFS, showed a small increase over the study course. Prevalence of clinically relevant overall fatigue, as defined by a PROMIS fatigue score ≥59, was 15.9% at baseline and increased to 19.8 % after 24 months. Conclusion The three fatigue measurements correlated moderately to strongly and showed small change over time. The relations of various risk factors with fatigue, including self-reported depression, were similar, irrespective of the measure used, indicating that the discrimination between these constructs is imperfect. Furthermore, we discovered that the overall level of fatigue in the study population was comparable to the general population and the prevalence of clinically relevant fatigue was less than reported previously. This is surprising, given the emphasis on fatigue as a significant outcome for patient receiving dialysis. To assess the experience and impact of fatigue in patients receiving hemodialysis, greater attention is warranted, particularly in the timing of fatigue, the time span studied, and the severity of fatigue, especially when investigating a specific fatigue treatment.

Dependency and frailty in the older haemodialysis patient

BackgroundFrailty among older adults undergoing hemodialysis is increasingly prevalent, significantly impacting cognitive function, mobility, and social engagement. This study focuses on the clinical profiles of very older adults in hemodialysis, particularly examining the interplay of dependency and frailty, and their influence on dialysis regimens.MethodsIn this observational, descriptive study, 107 patients aged over 75 from four outpatient centers and one hospital unit were examined over a year. Patient data encompassed sociodemographic factors, dialysis specifics, analytical outcomes, lifestyle elements, and self-reported post-treatment fatigue. Malnutrition-inflammation scale was used to measure the Nutritional status; MIS scale for malnutrition-inflammation, Barthel index for dependency, Charlson comorbidity index; FRIED scale for frailty and the SF12 quality of life measure.ResultsThe study unveiled that a substantial number of older adults on hemodialysis faced malnutrition (55%), dependency (21%), frailty (46%), and diminished quality of life (57%). Patients with dependency were distinctively marked by higher comorbidity, severe malnutrition, enhanced frailty, nursing home residency, dependency on ambulance transportation, and significantly limited mobility, with 77% unable to walk. Notably, 56% of participants experienced considerable post-dialysis fatigue, correlating with higher comorbidity, increased dependency, and poorer quality of life. Despite varying clinical conditions, dialysis patterns were consistent across the patient cohort.ConclusionsThe older adult cohort, averaging over four years on hemodialysis, exhibited high rates of comorbidity, frailty, and dependency, necessitating substantial support in transport and living arrangements. A third of these patients lacked residual urine output, yet their dialysis regimen mirrored those with preserved output. The study underscores the imperative for tailored therapeutic strategies to mitigate dependency, preserve residual renal function, and alleviate post-dialysis fatigue, ultimately enhancing the physical quality of life for these patients.

Defining, Understanding, and Addressing Postdialysis Fatigue: Takeaways from a Scientific Workshop Hosted by the National Institutes of Health.

Defining, Understanding, and Addressing Postdialysis Fatigue: Takeaways from a Scientific Workshop Hosted by the National Institutes of Health.

Effect of cold Dialysate on dialysis adequacy and post dialysis fatigue in regular Hemodialysis Patients

Effect of cold Dialysate on dialysis adequacy and post dialysis fatigue in regular Hemodialysis Patients

Personalizing electrolytes in the dialysis prescription: what, why and how?

Maintenance hemodialysis patients suffer from multiple comorbidities and treatment-related complications. A personalized approach to hemodialysis prescription could reduce some of these burdens by preventing complications such as excessive changes in blood pressure, arrhythmias, post-dialysis fatigue and decreased quality of life. A patient-centered approach to dialysate electrolyte concentrations represents one such opportunity. In addition to modifications in dialysate electrolyte concentrations, consideration of individual factors such as patients' serum concentrations, medication profiles, nutritional status and comorbidities is critical to tailoring hemodialysis prescriptions to optimize patient outcomes. The development of personalized dialysis treatment depends on the collection of comprehensive patient data, advances in technology, resource allocation and patient involvement in decision-making. This review discusses how the treatment of maintenance hemodialysis patients could benefit from individualized changes in certain dialysis fluid components.

Factors predicting post-dialysis fatigue of maintenance hemodialysis patients

AimsPost-dialysis fatigue is a common complication in maintenance hemodialysis patients. This study aims to evaluate post-dialysis fatigue and discover related risk factors.Design and methodsIn this cross-sectional study, we used the specific scale to measure post-dialysis fatigue of maintenance hemodialysis patients from June to September 2021, and looked for risk factors from sociodemographic and clinical data.ResultsThe post-dialysis fatigue score for 147 maintenance hemodialysis patients was 14.75 ± 8.24. The post-dialysis fatigue was associated with increasing age (b = 2.00, p = 0.016), fewer dialytic vintages (b = − 1.91, p = 0.001), increasing inter-dialysis weight gain (b = 5.79, p < 0.01), decreasing hemoglobin (b = − 3.30, p = 0.011) and Kt/V (b = − 2.74, p = 0.035).ConclusionsPatients with old age, dialytic vintage less than 36 months, poor control of inter-dialysis weight gain, anemia, and inadequate dialysis are more likely to suffer from post-dialysis fatigue.

Prevalence of post-dialysis fatigue: a systematic review and meta-analysis

ObjectivesThe purpose of this study was to synthesise data on the prevalence of post-dialysis fatigue (PDF) among haemodialysis (HD) patients.DesignSystematic review and meta-analysis.Data sourcesChina National Knowledge Infrastructure, Wanfang, Chinese Biological...

Association between corrected serum calcium levels after dialysis and post-dialysis fatigue risk: a hospital-based case–control study

ObjectivePost-dialysis fatigue (PDF) is an important problem in patients undergoing maintenance hemodialysis (MHD); however, evidence of the association between serum calcium after dialysis and the risk of PDF is limited and controversial. We explored this association among patients receiving MHD.MethodsWe carried out a case–control study of patients in the dialysis unit of Dalian Municipal Central Hospital between December 2019 and January 2020, including 340 patients with PDF and 270 patients without PDF. PDF was assessed by a \\validated self-administered questionnaire. Clinical variables were tested for multicollinearity using variance inflation factor analysis. Corrected serum calcium levels were categorized into three groups, with the lowest tertile used as the reference category. The odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for PDF risk were estimated using an unconditional logistic regression model.ResultAfter adjusting for potential confounders, corrected serum calcium levels showed a significant positive association with the risk of PDF (ORT3vs.T1 = 1.61, 95% CI = 1.01–2.58). Notably, after stratification by age, corrected serum calcium was also positively associated with the risk of PDF in patients aged ≥ 65 years (ORT3vs.T1 = 4.25, 95% CI 1.66–11.46). Furthermore, a significant linear trend and interaction were also observed (P < 0.05).DiscussionHigher corrected serum calcium levels after dialysis might increase the risk of PDF among MHD patients. However, further studies are warranted to confirm these findings.

Effect of Warm Water Foot Bath on Post Dialysis Fatigue in patients on Maintenance Hemodialysis

Aim: To evaluate the effectiveness of warm water foot bath therapy on post dialysis fatigue. Method: A Quasi experimental single group (pre and post-test) design was conducted in Nawaz Sharif Kidney Hospital, Swat. Single time intervention was provided to sixty (60) participants recruited through consecutive sampling technique. Demographic data were collected through self-structured interview and fatigue level was measured using Piper’s Fatigue Scale before and after foot bath therapy. The data were interred and analyzed through SPSS. Paired t-test was used to find out differences in mean while chi-square test was applied for association of fatigue score on the basis demography. To evaluate the effectiveness of the intervention paired t-test was calculated. Results: Cumulative pre-intervention fatigue score was 47.33±12.8 and post intervention cumulative fatigue score was 29.9±9.8. Mean of Pre-fatigue score of different groups made on the basis of demographic characteristics were not statistically different. Pre intervention individual mean fatigue sore was 5.25±142 while the post intervention was 3.33±1.09. A significant difference (P valve 0.000) was found between pre and post intervention individual mean fatigue score. Conclusion: Result of the study suggested that warm water foot bath therapy had therapeutic effects in decreasing post dialysis fatigue. It provides relief and promotes comfort level of the patients. Keywords: Nurses, hemodialysis, Fatigue, warm water foot bath

Exploring Fatigue Patterns and Associated Factors Among Patients on Hemodialysis

Fatigue in patients on hemodialysis varies based on disease and treatment situations. Most studies have assessed the effectiveness of interventions based on average fatigue during the past week. However, two different types of fatigue are identified: post-dialysis fatigue and continuous fatigue. Identifying different types of fatigue and related factors may facilitate the development of more-effective, type-specific measures to reduce patient fatigue. The purpose of this study was to explore fatigue patterns and predictors in patients on hemodialysis during their eight-day dialysis cycle. A perspective, observational research design was adopted. One hundred and two patients were recruited from three hospitals and one hemodialysis clinic in New Taipei City. During the dialysis, patients answered a structured questionnaire that included a demographic datasheet, Taiwanese depression questionnaire, hemodialysis social support scale, trait anxiety inventory, Pittsburgh sleep quality index, and fatigue visual analogy scale. After dialysis on each day, patients completed the fatigue visual analogy scale for a period of eight consecutive days every morning, noon, and night. Biochemical data and inter-dialysis weight gain were collected from medical charts. This study found three distinct fatigue status groups: fatigue adaptation, rapid change and continuous fatigue. After the day of dialysis, fatigue level was the lowest in the fatigue adaptation group, followed by the continuous fatigue group. The rapid change group reported the highest level of fatigue. With regard to the degree of increase in fatigue after dialysis (fatigue score after dialysis minus fatigue score before dialysis), the rapid change group had the highest average increase in score after dialysis, while the continuous fatigue group had the lowest. Sleep quality, trait anxiety, and health caregiver support were also found to be predictors of group affiliation. Nurses can provide individual social support interventions and methods to improve sleep quality and alleviate anxiety to reduce fatigue in patients on hemodialysis.

Effect of Guidelines Based Practice on Dialysis Complications in Patients on Permanent Hemodialysis

Background: Hemodialysis patients experienced a number of issues that led to early session termination, decreased waste removal, and ultimately decreased dialysis effectiveness. The dialysis unit's nursing staff struggles to care for these patients. An updated practice guideline is needed to provide the proper interventions to lower complications and improve patient outcomes. Long-term maintenance hemodialysis has also changed the way that patients with end-stage renal failure are treated, reducing the risk of death. Objective: To assess the effect of guidelines based practice on dialysis complications in patients on permanent hemodialysis. Methodology: A single group quasi experimental conducted in Sheikh Zayed Hospital Lahore Punjab Pakistan from 1 June to 15 August 2022, data was collected Through the use of a self-structured tool from 30 people receiving hemodialysis for at least six months. The validity and reliability of the tool were initially assessed. A systematic instruction workshop was offered to care providers following the pre data, and the previously described criteria were reassess. Result: According to this study, there were 60% men and 40% female, had age between 30 to 39 (43.3%) and mostly 70% belong to urban area. The McNemar test evaluated the reduction between the pre- and post-dialysis fatigue, headache, vomiting, nausea, breathlessness and cramps with statistical significance (P&lt;0.05). Practical implication: Patients receiving hemodialysis must need a complete nursing care in order to reduce dialysis induced complications. Conclusion: The significant reduction of dialysis complication after conducted dialysis on guideline base; it is recommended that dialysis be performed in accordance with the most recent clinical guidelines to improve hemodialysis procedures and boost hemodialysis efficacy. Keywords: Hemodialysis, Guidelines based practice and Dialysis Complications

Live music during haemodialysis: A multiple methods randomised controlled pilot study.

Fatigue is an immense problem among patients undergoing haemodialysis and is associated with anxiety and depression. Live music used in different hospital settings has shown promising effects, but the feasibility and potential effectiveness of live music during haemodialysis are unknown. To evaluate the feasibility, the participants' musical experience and potential effectiveness of live music on patients' levels of fatigue, relaxation, anxiety, depression, treatment satisfactionand work engagement among nurses. A pilot randomised controlled trial evaluated with a multiple methods design. Two clusters of 12 patients were each randomised to receive either 30 min of live music once a week during haemodialysis or usual care over a period of 6 weeks. The primary outcome was patients' immediate fatigue. Other outcomes were patients' long-term and post-dialysis fatigue, relaxation, anxiety, depression, treatment satisfactionand work engagement among nurses. Observations and semi-structured interviews with patients, nursesand musicians were conducted to gain an in-depth understanding of the musical experience as well as feasibility. The study was feasible and detected significant differences on immediate fatigue (p < 0.001) and anxiety (p < 0.012) in the intervention group compared to controls. Among 17 nurses, a significant difference was found in Dedication (p < 0.024). Furthermore, live music gave patients an uplifting experience, bringing joy and relaxationand the nurses experienced a sense of quietness in a stressful day. Providing live music performed by professional musicians in a haemodialysis setting is feasible and showed a significant effect on immediate fatigue and anxiety compared to controls.

Post-dialysis fatigue: Comparison of bicarbonate hemodialysis and online hemodiafiltration.

The present cross-sectional study aimed to compare the prevalence, the characteristics of post-dialysis fatigue and the length of recovery time after hemodialysis in prevalent end-stage renal disease patients (ESRD) receiving bicarbonate hemodialysis (HD) or hemodiafiltration (HDF). Patients were suffering from post-dialysis fatigue if they spontaneously offered this complaint when asked the open-ended question: "Do you feel fatigued after dialysis?". Moreover, each patient was invited to rate the intensity, duration, and frequency of post-dialysis fatigue from 1 to 5. In order to assess RECOVERY TIME AFTER DIALYSIS, patients were invited to answer to the following single open-ended question: "How long does it take you to recover from a dialysis session?" We included 335 patients: 252 received HD and 83 received HDF. Post-dialysis fatigue was present in 204 patients (60.9%). Prevalence of post-dialysis fatigue did not differ significantly between patients on HD (62.3%) and on HDF (56.6%; p=0.430). Median recovery time after dialysis was 180 min [180-240] and did not differ significantly between the two subgroups (180 min [130-240] and 240 min [120-332] p=0.671, respectively). Median post-dialysis fatigue intensity, duration, and frequency were 3 [1-5], 3 [1-5], and 4 [1-5] and did not differ significantly between patients on HD and on HDF. At the multivariate analysis, age, ADL and hemoglobin levels were the independent predictors of the HDF treatment. Prevalence and characteristics of post-dialysis fatigue do not differ significantly between patients receiving bicarbonate HD or HDF.

Assessment of the Impact of Fatigue on the Degree of Dependance in Hemodialysis Patients

Background: Patients undergoing hemodialysis (HD) go through a number of physical and emotional symptoms that can interfere with their comfort and quality of life, a common symptom is tiredness, a condition which is conventionally called post dialysis fatigue (PDF). Therefore, the objective is to evaluate the relationship between fatigue and the degree of dependence in performing basic and instrumental activities of daily living on patients undergoing hemodialysis. Method: Cross-sectional study, carried out at the hemodialysis unit of Hospital São Lucas da Pontificia Universidad Católica do Rio Grande do Sul.. The study reporting adheres to the STROBE checklist. Results: From the 101 patients interviewed, 63 (62.4%) had post dialysis fatigue, with a mean age of 59±7 years, where the majority were men with 66.3% (n=67). The presence of PDF was related to vintage on HD (p&lt;0,041), session recovery time (p&lt;0,000) and shift of the session (p&lt;0.001). There was no association of PDF with the degree of dependence on basic and instrumental activities of daily living. Conclusion: More than half of the patients on HD experience PDF, it is less frequent in patients dialyzing in the night shift and it is associated with dialysis vintage and with greater recovery time.