Investigation of the Causes of Fatigue in Dialysis Patients

 

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Investigation of the Causes of Fatigue in Dialysis Patients

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Naoki
Fujiwara
Naoki Fujiwara t226060c@yokohama-cu.ac.jp Yokohama City University Graduate School of Medicine Department of Medical Science and Cardiorenal Medicine Yokohama Japan *
Yusuke Kobayashi yusuke@yokohama-cu.ac.jp Yokohama City University YCU Co-creation Innovation Center Yokohama Japan -
Ryutaro Morita t226068d@yokohama-cu.ac.jp Yokohama City University Graduate School of Medicine Department of Medical Science and Cardiorenal Medicine Yokohama Japan -
Hiromichi Wakui hiro1234@yokohama-cu.ac.jp Yokohama City University Graduate School of Medicine Department of Medical Science and Cardiorenal Medicine Yokohama Japan -
Koichi Tamura tamukou@yokohama-cu.ac.jp Yokohama City University Graduate School of Medicine Department of Medical Science and Cardiorenal Medicine Yokohama Japan -
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Fatigue in hemodialysis(HD) patients has been reported to be associated with reduced quality of life (QOL), increased mortality, and a decline in physical function. Our research group previously reported on the relationship between fatigue and the number of medications in patients with non-communicable diseases (NCDs) (Fujiwara N, Kobayashi Y et al., 69th Annual Meeting of the Japanese Society for Dialysis Therapy). In this study, we aimed to explore dialysis-specific causes of fatigue by comparing dialysis patients with NCD patients.

A questionnaire survey using the Japanese version of the Multidimensional Fatigue Inventory (MFI-J) was conducted with 331 HD patients and 52 patients with NCDs. We compared and evaluated five fatigue domains (General fatigue, Physical fatigue, Reduced activity, Reduced motivation, Mental fatigue). Patient characteristics and biochemical profiles were also compared between the two groups.

The average age of the participants was 70.1 years, and the male-to-female ratio was95:74(unanswered14). Compared to NCD patients, HD patients showed significantly higher scores in MFI total score(56.6 vs 52.8,p=0.04), Physical fatigue(12.5 vs 11.3,p=0.01), and Reduced activity(11.0 vs 9.4,p<0.01). In the HD group, a multiple linear regression analysis was performed with the items as dependent variables and age, sex, BMI, dialysis duration, hemoglobin, and smoking history as explanatory variables. Age showed a significant positive association with Reduced activity (B = 0.058, t = 2.371, p = 0.019). No significant associations were found between the other two items and any of the explanatory variables, however, dialysis duration showed a trend toward a positive correlation with fatigue (Physical fatigue: p = 0.08; Reduced activity: p = 0.07).

Fatigue in HD patients was found to be more pronounced compared to patients with NCDs, and certain factors were associated with fatigue. There was also a tendency for fatigue to worsen gradually after the initiation of dialysis, suggesting the need for future longitudinal investigations. However, the mechanisms underlying these associations remain unclear. Further detailed analyses and a literature review will be presented in the final report.

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