Do biochemical parameters and intradialytic symptoms affectpost‐dialysisrecovery time? A prospective, descriptive study

Abstract

The recovery time is defined as the time required to recover from the feelings of lassitude and fatigue. The daily activities of patients are affected by dialysis sessions, requiring significant time for patients to return to their routines. This situation implies a lower quality of life for HD patients. The aim of this study was to investigate the effects of biochemical parameters and intradialytic symptoms on post-dialysis recovery time in maintenance HD patients. This study was conducted at a private dialysis center during June and August 2019. Data were collected using the "Descriptive Characteristics Form" and the "Dialysis Symptom Index." "STROBE check-list" was used for the report of the study. The study was completed with 86 participants. The median post-dialysis recovery time was 240 min (interquartile range, 120-360 min), and female patients exhibit significantly higher recovery time than male patients. The median BMI was statistically significantly higher in patients whose post-dialysis recovery time was ≥240 min. Additional findings show that the post-dialysis recovery time was shortened by 0.230 times for male patients, while intradialytic hypotension (IDH) prolonged the median post-dialysis recovery time by 3.141 times. Factors underlying the IDH should be determined in order to eradicate the issue. The study was registered in ClinicalTrials.gov with the number NCT04274556.body mass index, female gender, intradialytic hypotension, intradialytic symptoms, post-dialysis recovery time | INTRODUCTIONPatients undergoing HD can experience symptoms such as lassitude, pain, muscle cramps, nausea, vomiting, constipation, diarrhea, rash, skin dryness, sleep disorders, depression, anxiety, and emotional and sexual problems after the treatment [1,2]. Many chronic HD patients do not feel well after the treatment sessions and need some time to recover. This recovery time is defined as the time required to recover from the feelings of lassitude and fatigue. The daily routines and work life of the patients were negatively affected, so a significant amount of time is required to recover [3,4].The Dialysis Outcomes and Practice Study reported that the recovery time for patients under 2, 2-6, 7-12, and >12 h were 32%, 42%, 17% and 10% respectively [5].

Post‐dialysis recovery time in ESRD patients receiving more frequent hemodialysis in skilled nursing facilities

“…Intradialytic hypotension was expected to tax the patient's system and reduce the proportion experiencing rapid recovery. Consistent with these expectations and some prior studies, 9,10,30 IDH was associated with reduced rapid return to baseline with 0.91 odds ratio (CI: 0.84-0.99; p = 0.025) (Table 3). We expected patients missing their previous dialysis session to be less likely to have short DRT.…”

“…The finding of better recovery time in Hispanics is unexplained by gender or age differences, but we did observe a higher proportion of Hispanics (19% vs. 11%) with pre‐HD sBP in the range 160–179 mmHg, which conferred higher odds of rapid recovery time. Of note, gender was not a statistically significant influence on recovery, a finding that agreed with Bossola 33 and Awuah 35 but contrasts with reports by other researchers 6,9,10,30,36 …”

“…Of note, gender was not a statistically significant influence on recovery, a finding that agreed with Bossola 33 and Awuah 35 but contrasts with reports by other researchers. 6,9,10,30,36 The Intraclass Correlation Coefficient of 0.76 (95% CI, 0.73-0.78) indicates that 76% of the variability in proportion of patients with recovery ≤2 h is explained by a tendency for individual patients to have a consistent experience and/or report of recovery. Patients tended to report a consistent recovery time across multiple surveys-a finding that intuitively makes sense, as we can imagine a characteristic frailty, experience, perception, and/or reporting inclination, which might be patient idiosyncratic.…”

“…The duration of this period, known as post‐dialysis recovery time (DRT), has been characterized through a validated patient questionnaire 1 . In the general ESRD population receiving conventional dialysis, DRT is inversely correlated with multiple quality of life and physical symptom assessments, 2–5 and several studies document more than half of patients with DRT greater than 2 h 6–9 . Prolonged DRT is associated with increased hospitalization 6,10 and mortality 6 .…”

“…The duration of this period, known as post-dialysis recovery time (DRT), has been characterized through a validated patient questionnaire. 1 In the general ESRD population receiving conventional dialysis, DRT is inversely correlated with multiple quality of life and physical symptom assessments, [2][3][4][5] and several studies document more than half of patients with DRT greater than 2 h. [6][7][8][9] Prolonged DRT is associated with increased hospitalization 6,10 and mortality. 6 A more frequent dialysis (MFD) treatment schedule has been associated with improvements in patient quality of life and laboratory measurements, 11 and in a randomized controlled trial, six times per week MFD compared to conventional dialysis resulted in improved fluid management 12 and reduced hospitalization rates 13 and mortality.…”