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J Pain Symptom Manage. 2019 Dec 19. pii: S0885-3924(19)31056-5. doi: 10.1016/j.jpainsymman.2019.12.351. [Epub ahead of print]

Fatigue in peritoneal dialysis patients and an exploration of contributing factors: a cross-sectional study.

Author information

1
School of Nursing, Tongji Medical College, Huazhong University of Science and Technology. Wuhan, 430030, Hubei, China.
2
Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
3
Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
4
Department of Clinical Nutrition, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China. Electronic address: zuo1967@tjh.tjmu.edu.cn.

Abstract

CONTEXT:

Fatigue is a common and detrimental symptom in dialysis patients; however, our understanding of it and investigation of its contributing factors is still very limited, especially in peritoneal dialysis patients.

OBJECTIVES:

To assess fatigue in peritoneal dialysis patients and identify contributing factors.

METHODS:

One hundred and eight peritoneal dialysis patients in a comprehensive hospital in China were recruited. The fatigue severity of the participants was assessed using the Chalder fatigue scale 11. Demographic factors and results of physiological tests were collected. Quality of sleep, mental health, and social support were assessed with the Pittsburgh Sleep Quality Index, Symptom checklist 90, and Social Support Rating Scale, respectively. Multiple linear regression models were conducted with candidate variables with a p-value of less than 0.1 on univariate analysis and variables that were clinically relevant to identify contributing factors for fatigue.

RESULTS:

The fatigue level in peritoneal dialysis patients was significantly higher than the community population, and 78.7% of them were suffering from fatigue. The factors that were significantly associated with fatigue were quality of sleep, normalized protein nitrogen appearance (nPNA), Transferrin, alkaline phosphatase and total cholesterol (Adjusted R squared value 0.86). Among them, quality of sleep, Transferrin, alkaline phosphatase, and total cholesterol were significant contributors for physical fatigue, while the quality of sleep and nPNA were contributing factors for mental fatigue.

CONCLUSION:

Fatigue is a common symptom in peritoneal dialysis patients, suggesting that increased awareness of this symptom is required. The identification of correlates by extensive exploration of multidimensional factors in this study may help practitioners to identify patients at higher risk and to develop a multidimensional and targeted intervention plan.

KEYWORDS:

Fatigue; mental health; peritoneal dialysis; quality of sleep; social support

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