Fatigue is associated with high prevalence and severity of physical and emotional symptoms in patients on chronic hemodialysis

Bossola, Maurizio; Stasio, Enrico Di; Marzetti, Emanuele; Lorenzis, Katja De; Pepe, Gilda; Vulpio, Carlo

doi:10.1007/s11255-018-1875-0

Cited by 28 publications

(43 citation statements)

References 48 publications

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“…Inactivity in ESKD is likely influenced by high prevalence of physical disabilities and comorbidities, and social, environmental, and patient characteristics [3,4,[9][10][11][12][13][14][15]. Albeit lifesaving, dialysis can be associated with symptoms such as nausea, body aches, and fatigue impacting PA [12,16,17]. Understanding profiles and drivers of PA in ESKD is important to find optimal treatment options and design interventions.…”

Section: Introductionmentioning

confidence: 99%

Impact of hemodialysis and post-dialysis period on granular activity levels

Larkin

Han

et al. 2020

BMC Nephrol

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Background: Physical activity (PA) is typically lower on hemodialysis (HD) days. Albeit intradialytic inactivity is expected, it is unknown whether recovery after HD contributes to low PA. We investigated the impact of HD and post-HD period on granular PA relative to HD timing. Methods: We used baseline data from the HDFIT trial conducted from August 2016 to October 2017. Accelerometry measured PA over 1 week in patients who received thrice-weekly high-flux HD (vintage 3 to 24 months), were clinically stable, and had no ambulatory limitations. PA was assessed on HD days (0 to ≤24 h after start HD), first non-HD days (> 24 to ≤48 h after start HD) and second non-HD day (> 48 to ≤72 h after start HD). PA was recorded in blocks/slices: 4 h during HD, 0 to ≤2 h post-HD (30 min slices), and > 2 to ≤20 h post-HD (4.5 h slices). Blocks/slices of PA were captured at concurrent/parallel times on first/second non-HD days compared to HD days. Results: Among 195 patients (mean age 53 ± 15 years, 71% male), step counts per 24-h were 3919 ± 2899 on HD days, 5308 ± 3131 on first non-HD days (p < 0.001), and 4926 ± 3413 on second non-HD days (p = 0.032). During concurrent/parallel times to HD on first and second non-HD days, patients took 1308 and 1128 more steps (both p < 0.001). Patients took 276 more steps and had highest rates of steps/hour 2-h post-HD versus same times on first non-HD days (all p < 0.05). Consistent findings were observed on second non-HD days. Conclusions: PA was higher within 2-h of HD versus same times on non-HD days. Lower PA on HD days was attributable to intradialytic inactivity. The established PA profiles are of importance to the design and development of exercise programs that aim to increase activity during and between HD treatments. Trial registration: HDFIT was prospectively registered 20 April 2016 on ClinicalTrials.gov (NCT02787161)

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Section: Introductionmentioning

confidence: 99%

Impact of hemodialysis and post-dialysis period on granular activity levels

Larkin

Han

et al. 2020

BMC Nephrol

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“…Kidney transplantation (KT) is the optimal renal replacement therapy (RRT) option for many patients with ESKD as it improves survival and HRQOL . Despite its overall benefits, KT is not a cure for ESKD and many kidney transplant recipients (KTR) still experience physical and emotional symptoms .…”

Section: Introductionmentioning

confidence: 99%

Evaluating symptom burden in kidney transplant recipients: validation of the revised Edmonton Symptom Assessment System for kidney transplant recipients – a single‐center, cross‐sectional study

et al. 2020

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Summary We assessed the validity of the Edmonton Symptom Assessment System (ESAS‐r) in kidney transplant recipients (KTR). A cross‐sectional sample of 252 KTR was recruited. Individual ESAS‐r symptom scores and symptom domain scores were evaluated. Internal consistency, convergent validity, and construct validity were assessed with Cronbach’s α, Spearman’s rank correlations, and a priori‐defined risk group comparisons. Mean (SD) age was 51 (16), 58% were male, and 58% Caucasian. ESAS‐r Physical, Emotional, and Global Symptom Scores demonstrated good internal consistency (α > 0.8 for all). ESAS‐r Physical and Global Symptom Scores strongly correlated with PHQ‐9 scores (0.72, 95% CI: 0.64–0.78 and 0.74, 95% CI: 0.67–0.80). For a priori‐defined risk groups, individual ESAS‐r symptom score differed between groups with lower versus higher eGFR [pain: 1 (0–3) vs. 0 (0–2), delta = 0.18; tiredness: 3 (1–5) vs. 1.5 (0–4), delta = 0.21] and lower versus higher hemoglobin [tiredness: 3 (1–6) vs. 2 (0–4), delta = 0.27]. ESAS‐r Global and Physical Symptom Scores differed between groups with lower versus higher hemoglobin [13 (6–29) vs. 6.5 (0–18.5), delta = 0.3, and 9 (2–19) vs. 4 (0–13), delta = 0.24] and lower versus higher eGFR [11 (4–20) vs. 6.5 (2–13), delta = 0.21, and 7 (2–16) vs. 3 (0–9), delta = 0.26]. These data support reliability and construct validity of ESAS‐r in KTR. Future studies should explore its clinical utility for symptom assessment among KTR.

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“…[3][4][5][6][7][8] Inactivity in ESKD is likely influenced by high prevalence of physical disabilities and comorbidities, and social, environmental, and patient characteristics. [3, 4, 9-15] Albeit lifesaving, dialysis can be associated with symptoms such as nausea, body aches, and fatigue impacting PA. [12,16,17] Understanding profiles and drivers of PA in ESKD is important to find optimal treatment options and design interventions.…”

Section: Introductionmentioning

confidence: 99%

Impact of Hemodialysis and Post-Dialysis Period on Granular Activity Levels

Larkin

Han

et al. 2020

Preprint

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Background: Physical activity (PA) is typically lower on hemodialysis (HD) days. Albeit intradialytic inactivity is expected, it is unknown whether recovery after HD contributes to low PA. We investigated the impact of HD and post-HD period on granular PA relative to HD timing. Methods: We used baseline data from the HDFIT trial conducted from August 2016 to October 2017. Accelerometry measured PA over one week in patients who received thrice-weekly high-flux HD (vintage 3 to 24 months), were clinically stable, and had no ambulatory limitations. PA was assessed on HD days (0 to ≤24 hours after start HD), first non-HD days (>24 to ≤48 hours after start HD) and second non-HD day (>48 to ≤72 hours after start HD). PA was recorded in blocks/slices: 4 hours during HD, 0 to ≤2 hours post-HD (30 minute slices), and >2 to ≤20 hours post-HD (4.5 hour slices). Blocks/slices of PA were captured at concurrent/parallel times on first/second non-HD days compared to HD days. Results: Among 195 patients (mean age 53±15 years, 71% male), step counts per 24-hours were 3919±2899 on HD days, 5308±3131 on first non-HD days (p<0.001), and 4926±3413 on second non-HD days (p=0.032). During concurrent/parallel times to HD on first and second non-HD days, patients took 1308 and 1128 more steps (both p<0.001). Patients took 276 more steps and had highest rates of steps/hour 2-hours post-HD versus same times on first non-HD days (all p<0.05). Consistent findings were observed on second non-HD days. Conclusions: PA was higher within 2-hours of HD versus same times on non-HD days. Lower PA on HD days was attributable to intradialytic inactivity. The established PA profiles are of importance to the design and development of exercise programs that aim to increase activity during and between HD treatments. Trial Registration: HDFIT was registered 20 April 2016 on ClinicalTrials.gov (NCT02787161) https://clinicaltrials.gov/ct2/show/NCT02787161.

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Fatigue is associated with high prevalence and severity of physical and emotional symptoms in patients on chronic hemodialysis

Cited by 28 publications

References 48 publications

Impact of hemodialysis and post-dialysis period on granular activity levels

Impact of hemodialysis and post-dialysis period on granular activity levels

Evaluating symptom burden in kidney transplant recipients: validation of the revised Edmonton Symptom Assessment System for kidney transplant recipients – a single‐center, cross‐sectional study

Impact of Hemodialysis and Post-Dialysis Period on Granular Activity Levels

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