[Fatigue in elderly patients on dialysis]

Fatigue is a common symptom in dialysis patients. This study was carried out to evaluate the impact of the dialysis modality on the fatigue of dialysis patients.

This was a cross-sectional study of dialysis patients older than 70 years treated by haemodialysis or peritoneal dialysis for more than three months during June 2006 in one dialysis centre. Fatigue was assessed by the multidimensional fatigue inventory questionnaire (MFI) in 33 dialysis patients. Patients with a MMSE of less than 22 were excluded from the study. There was also a control group of 21 patients without chronic disease.

Dialysis patients had a greater fatigue score than nondialysis patients for the five fatigue dimensions (general fatigue score: 14+/-3 versus 10.8+/-4, p<0.01). The were no significant difference between haemodialysis patients (17) and peritoneal dialysis patients (16) regarding the mean age (77+/-5 versus 77+/-5), the mean modified Charlson index (6.3+/-2.5 versus 6.3+/-2.4), the mean MMSE (26+/-2 versus 25+/-2), the mean Activity of Daily Living score (5.6+/-0.8 versus 5.3+/-1) and the mean Geriatric Depression Score (0.7+/-0.9 versus 1+/-1). Duration on dialysis was not different between the two groups (28+/-18 versus. 49+/-52 months). Haemoglobin (12+/-1 versus 12+/-1g/dl), parathormone (227+/-140 versus 324+/-269 ng/l) and CRP blood level were similar between the two groups (13+/-13 versus 10+/-9 mg/l). Peritoneal dialysis patients had a lower serum albumin level than haemodialysis patient (32+/-6 versus 38+/-8, p<0.05). Peritoneal dialysis patients had a lower psychic fatigue score than haemodialysis patients (9+/-3.5 versus 11.6+/-3, p<0.05). Patients with a CRP level greater than 5mg/l had a greater general fatigue score compared with other patients (14.5+/-3 versus 12+/-3, p<0.05). In addition patients with a modified Charlson index above 5 had a greater physical fatigue score than other patients (15+/-3 versus 12.6+/-4, p<0.05).

Fatigue score are high in elderly dialysis compared with nondialysis patients. Dialysis modality may have an impact on the fatigue of dialysis patients. Inflammation and comorbidities play a role in the dialysis fatigue.