School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
J Pain Symptom Manage. 2020 May;59(5):1074-1081.e2. doi: 10.1016/j.jpainsymman.2019.12.351. Epub 2019 Dec 20.
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 (PD) patients.
To assess fatigue in PD patients and identify contributing factors.
One hundred eight PD 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.
The fatigue level in PD 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, transferrin, alkaline phosphatase, and total cholesterol (adjusted R squared 0.86). Among them, quality of sleep, transferrin, alkaline phosphatase, and total cholesterol were significant contributors for physical fatigue, whereas the quality of sleep and normalized protein nitrogen appearance were contributing factors for mental fatigue.
Fatigue is a common symptom in PD 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.
疲劳是透析患者常见且有害的症状；然而，我们对其的理解以及对其致病因素的研究仍然非常有限，尤其是在腹膜透析（PD）患者中。
评估 PD 患者的疲劳程度并确定其致病因素。
在中国一家综合医院招募了 108 名 PD 患者。采用 Chalder 疲劳量表 11 评估参与者的疲劳严重程度。收集人口统计学因素和生理测试结果。使用匹兹堡睡眠质量指数、症状清单 90 和社会支持评定量表分别评估睡眠质量、心理健康和社会支持。采用多元线性回归模型，对单因素分析中 P 值小于 0.1 的候选变量和与临床相关的变量进行分析，以确定疲劳的致病因素。
PD 患者的疲劳水平明显高于社区人群，78.7%的患者存在疲劳。与疲劳显著相关的因素有睡眠质量、校正蛋白氮表观率、转铁蛋白、碱性磷酸酶和总胆固醇（调整后的 R 平方值为 0.86）。其中，睡眠质量、转铁蛋白、碱性磷酸酶和总胆固醇是体力疲劳的重要致病因素，而睡眠质量和校正蛋白氮表观率是精神疲劳的致病因素。
疲劳是 PD 患者的常见症状，这表明需要提高对该症状的认识。本研究通过广泛探索多维因素来确定相关因素，这可能有助于临床医生识别高风险患者，并制定多维和有针对性的干预计划。
