Identification of Modifiable Factors Associated With Fatigue and Dialysis Recovery Time

Fatigue and dialysis recovery time (DRT) are important patient-reported outcomes that can affect the well-being and survival of patients receiving hemodialysis. Mabel Aoun, MD, and colleagues conducted a study to identify modifiable dialysis-related factors associated with fatigue and DRT so that they might be addressed in future trials. 

The researchers conducted a multicenter, observational study of adults receiving chronic hemodialysis for more than three months in December 2023. Hospitalized patients and those with active cancer or cognitive problems were not included. In sum, 536 patients and 2,967 sessions were studied. The mean patient age was 68.1±14.3 years and 60.9% were male. In addition, 33.2% had diabetes and 63.3% were receiving hemodiafiltration.  

Fatigue was assessed by utilizing the French-validated Standardized Outcomes in Nephrology-Hemodialysis fatigue scale. DRT was identified by asking patients, “How long did it take you to recover from your last dialysis session?” over six sessions. The researchers used logistic regression analysis to evaluate the association between DRT >12 hours and a fatigue score of four or higher with all dialysis-related factors. They also conducted a subanalysis of DRT-related factors for patients aged 85 years and older. 

Median dialysate sodium was 138 (136–140). Fatigue score was 3.1±2.3, 37.7% of patients had a score of four or higher, and 18% experienced no fatigue. Median DRT was 140 (45–440) minutes, but 14.9% of patients had a DRT >12 hours.  

DRT was significantly associated with fatigue scores. Multivariable regression analysis found that intradialytic reduction in serum sodium and frequency of dialysis were significantly associated with DRT. Female sex and lower hemoglobin were associated with fatigue. Among the patients aged 85 years and older, hemodiafiltration was associated with sustained DRT. 

In summary, modifiable factors associated with prolonged DRT are not strictly the same as those associated with fatigue, but “modifiable factors can be addressed in future interventional trials to improve patients’ outcomes,” the authors wrote. 

Source: Kidney360.