Nephrology and Internal Medicine Department, Faculty of Medicine, Alexandria University, Alkhartoom square, El azareeta, Alexandria, 21131, Egypt.
BMC Nephrol. 2022 Sep 1;23(1):298. doi: 10.1186/s12882-022-02926-0.
Post-dialysis fatigue is a common and distressing complaint in patients on hemodialysis (HD). The dialysis recovery time (DRT) is a recent and reliable method of Post-dialysis fatigue assessment. We aimed to identify factors affecting the DRT and its relation with HD patients' quality of life.
This is a cross-sectional study carried out on end-stage renal disease patients on regular HD. All participants underwent detailed history taking and complete physical examination, and data on dialysis and laboratory investigations were also collected. Patients were asked "How long does it take you to recover from a dialysis session?" to calculate the DRT. We used the Malnutrition-Inflammation Score (MIS) and KDQOL-36 questionnaire to assess patients' nutritional status and quality of life, respectively.
Two hundred and ten patients were screened and 191, with a median age of 47 years, completed the study. Patients had a median DRT of 300 minutes (range: 0.0-2880.0), with 55% of patients reporting a DRT of > 240 minutes and 22.5% of them reporting a DRT of < 30 minutes. Patients had a median MIS score of 7 (range: 0-17). There was a statistically significant negative relation between the DRT and symptom/ problem list (p < 0.001), effects of kidney disease (p < 0.001), burden of kidney disease (p < 0.001), SF-12 physical composite (p = 0.001), and SF-12 mental composite (p < 0.001) of KDQOL. The results of multivariate analyses showed that dialysate Na (p = 0.003), and the number of missed sessions (p < 0.001) were independently correlated with the DRT.
Decreased dialysate Na, and increased number of missed sessions were predictors of prolonged DRT. Patients with prolonged DRT were associated with poorer quality of life. Further randomized clinical trials are needed to assess strategies to minimize the DRT and, perhaps, enhance clinical outcomes.
ClinicalTrials.gov Identifier: NCT04727281. First registration date: 27/01/2021.
透析后疲劳是血液透析（HD）患者常见且令人痛苦的主诉。透析恢复时间（DRT）是一种最近且可靠的透析后疲劳评估方法。我们旨在确定影响 DRT 的因素及其与 HD 患者生活质量的关系。
这是一项在常规 HD 的终末期肾病患者中进行的横断面研究。所有参与者均接受详细的病史询问和全面的体格检查，并收集了透析和实验室检查的数据。我们询问患者“您需要多长时间才能从透析治疗中恢复过来？”以计算 DRT。我们分别使用营养不良-炎症评分（MIS）和 KDQOL-36 问卷来评估患者的营养状况和生活质量。
筛选了 210 名患者，其中 191 名年龄中位数为 47 岁的患者完成了研究。患者的 DRT 中位数为 300 分钟（范围：0.0-2880.0），55%的患者报告 DRT 大于 240 分钟，22.5%的患者报告 DRT 小于 30 分钟。患者的 MIS 评分中位数为 7 分（范围：0-17）。DRT 与症状/问题列表（p<0.001）、肾脏疾病的影响（p<0.001）、肾脏疾病负担（p<0.001）、SF-12 身体综合评分（p=0.001）和 SF-12 心理综合评分（p<0.001）呈显著负相关。多变量分析的结果表明，透析液钠（p=0.003）和错过的透析次数（p<0.001）与 DRT 独立相关。
透析液钠减少和错过的透析次数增加是 DRT 延长的预测因素。DRT 延长的患者与较差的生活质量相关。需要进一步的随机临床试验来评估减少 DRT 并改善临床结局的策略。
ClinicalTrials.gov 标识符：NCT04727281。首次注册日期：2021 年 1 月 27 日。
