Bossola Maurizio, Ciferri Nunzia, Mariani Ilaria, Monteburini Tania, Santarelli Stefano, Di Stasio Enrico
Servizio Emodialisi, Dipartimento di Scienze Mediche e Chirurgiche, Università Cattolica del Sacro Cuore, 00168 Roma, Italy.
Policlinico Universitario Fondazione Agostino Gemelli IRCCS, 00168 Roma, Italy.
J Clin Med. 2025 Apr 15;14(8):2706. doi: 10.3390/jcm14082706.
To measure the peri-dialytic serum lactate, sodium, potassium, calcium, and pH and base excess in chronic hemodialysis patients with and without post-dialysis fatigue (PDF). : Patients were asked "Do you feel fatigued after dialysis?" Each patient was invited to rate the intensity, duration, and frequency of PDF from one to five. The recovery time after the hemodialysis session (TIRD) was calculated, and inviting patients were to answer the following single open-ended question: "How long does it take you to recover from a dialysis session?" Pre- and post-dialysis arterial blood was sampled, and pH, bicarbonates, base excess, sodium, calcium, potassium, and lactate were measured. One hundred fifty-eight patients were included in the study. One hundred seventeen patients declared to suffer from PDF and forty-one did not. Median [range] PDF frequency, intensity, duration, and TIRD were 5 (1-5), 4 (1-5), 3 (1-5), and 12 h (1-48), respectively. Seventy patients had a TIRD ≤ 12 h and forty-seven had a TIRD > 12 h. Median post-dialysis and post-dialysis/pre-dialysis difference serum lactate levels (mmol/L) did not differ between patients with and without PDF ( = 0.111 and = 0.395, respectively). In addition, the distribution of patients according to post-dialysis serum lactate levels was similar in the presence or absence of PDF. The median post-dialysis and post-dialysis/pre-dialysis difference serum lactate concentrations did not differ significantly according to the score of the PDF intensity and PDF duration ( = 0.928 and 0.935, = 0.610 and 0.548, respectively). Finally, we stratified patients into two groups according to the length of TIRD: ≤12 h and >12 h. The median post-dialysis serum lactate concentrations did not differ significantly between the two groups ( = 0.862) as well as the median post-dialysis/pre-dialysis difference ( = 0.583). Also, the distribution of patients according to post-dialysis serum lactate levels was similar in the two groups. PDF and TIRD are not associated with peri-dialytic changes in serum lactate in patients on chronic hemodialysis.
测量有和没有透析后疲劳（PDF）的慢性血液透析患者透析期间的血清乳酸、钠、钾、钙、pH值和碱剩余。：询问患者“透析后你感到疲劳吗？”邀请每位患者对PDF的强度、持续时间和频率从1到5进行评分。计算血液透析 session 后的恢复时间（TIRD），并邀请患者回答以下单一开放式问题：“你从一次透析 session 中恢复需要多长时间？”采集透析前和透析后的动脉血样，测量pH值、碳酸氢盐、碱剩余、钠、钙、钾和乳酸。158名患者纳入研究。117名患者宣称患有PDF，41名患者没有。PDF频率、强度、持续时间和TIRD的中位数[范围]分别为5（1 - 5）、4（1 - 5）、3（1 - 5）和12小时（1 - 48）。70名患者的TIRD≤12小时，47名患者的TIRD>12小时。有和没有PDF的患者透析后及透析后/透析前血清乳酸水平差异的中位数（mmol/L）无差异（分别为 = 0.111和 = 0.395）。此外，无论有无PDF，根据透析后血清乳酸水平的患者分布相似。根据PDF强度和PDF持续时间的评分，透析后及透析后/透析前血清乳酸浓度差异的中位数无显著差异（分别为 = 0.928和0.935， = 0.610和0.548）。最后，我们根据TIRD的长短将患者分为两组：≤12小时和>12小时。两组透析后血清乳酸浓度的中位数无显著差异（ = 0.862），透析后/透析前差异的中位数也无显著差异（ = 0.583）。而且，两组中根据透析后血清乳酸水平的患者分布相似。慢性血液透析患者的PDF和TIRD与透析期间血清乳酸的变化无关。
