Alvarez Luis, Brown Deborah, Hu Dean, Chertow Glenn M, Vassalotti Joseph A, Prichard Sarah
Palo Alto Medical Foundation, Palo Alto, CA.
D. Brown Consulting, LLC, Palo Alto, CA.
Kidney Med. 2019 Dec 20;2(2):125-130. doi: 10.1016/j.xkme.2019.10.010. eCollection 2020 Mar-Apr.
RATIONALE & OBJECTIVE: Patients experience various symptoms during hemodialysis. We aimed to assess the frequency and severity of symptoms during hemodialysis and whether intradialytic symptoms are associated with recovery time postdialysis.
An online questionnaire was sent to 10,000 patients in a National Kidney Foundation database.
SETTING & PARTICIPANTS: Adult patients receiving in-center hemodialysis 3 times weekly for 3 or more months.
Online questionnaire.
Tabulation of frequency and severity of events and recovery time as percent of respondents, construction of a total symptom score, followed by rank correlation analysis of symptom characteristics with total recovery time.
Patient-reported intradialytic symptoms and recovery time postdialysis.
359 patients met screening criteria and completed the questionnaire. Mean age was 62.5 ± 13.8 years, 207 (58%) were men, 74 (21%) were black/African American, 132 (37%) had diabetes, 252 (70%) had hypertension, and 102 (28%) had a history of myocardial infarction, heart surgery, or stent placement. 311 (87%) patients had symptoms during dialysis in the previous week, with mean severity of 2.7 (range for each symptom, 1-5). The most common symptoms were fatigue/feeling washed out (62%), cramps (44%), and symptoms of low blood pressure (42%). Median time to recovery was 3 (range, 0-24) hours, and this correlated with the incidence and severity of intradialytic symptoms ( < 0.0001). 40% of patients had time to recovery times of 4 hours or longer. 1 in 3 patients reported having stopped dialysis early for intradialytic symptoms and 6% reported skipping dialysis at least once because of intradialytic symptoms.
Recall-based self-reported data with a relatively low response rate.
A majority of patients receiving in-center hemodialysis experience symptoms such as feeling washed out, fatigue, and cramping; these may be severe and are correlated with longer recovery time following hemodialysis, as well as shortened and skipped hemodialysis sessions.
患者在血液透析过程中会经历各种症状。我们旨在评估血液透析期间症状的频率和严重程度，以及透析期间的症状是否与透析后恢复时间相关。
向国家肾脏基金会数据库中的10,000名患者发送了在线调查问卷。
每周进行3次中心血液透析3个月或更长时间的成年患者。
在线调查问卷。
按事件的频率和严重程度以及恢复时间占受访者的百分比进行列表，构建总症状评分，然后对症状特征与总恢复时间进行等级相关分析。
359名患者符合筛查标准并完成了问卷。平均年龄为62.5±13.8岁，男性207名（58%），黑人/非裔美国人74名（21%），糖尿病患者132名（37%），高血压患者252名（70%），有心肌梗死、心脏手术或支架置入史的患者102名（28%）。311名（87%）患者在前一周透析期间出现症状，平均严重程度为2.7（每种症状的范围为1 - 5）。最常见的症状是疲劳/感觉精疲力竭（62%）、痉挛（44%）和低血压症状（42%）。恢复的中位时间为3小时（范围为0 - 24小时），这与透析期间症状的发生率和严重程度相关（<0.0001）。40%的患者恢复时间为4小时或更长。三分之一的患者报告因透析期间的症状提前停止透析，6%的患者报告因透析期间的症状至少跳过一次透析。
基于回忆的自我报告数据，回复率相对较低。
大多数接受中心血液透析的患者会经历如精疲力竭、疲劳和痉挛等症状；这些症状可能很严重，并且与血液透析后更长的恢复时间以及缩短和跳过血液透析疗程相关。
