Effect of Acupressure on Fatigue in Hemodialysis Patients: A Single-Blinded Randomized Controlled Trial

The objective of this study was to investigate the effect of acupressure on fatigue severity, sleep quality, and psychological status in patients with end-stage renal disease (ESRD) receiving hemodialysis (HD) treatment. A single-blinded parallel-group randomized controlled trial. A medical center in central Java, Indonesia. One hundred and six patients who had been receiving HD for at least 3 months were enrolled in this study and randomly assigned to two groups. The experimental group received acupressure at K1, ST36, and SP6 acupoints. In contrast, the control group received sham acupressure at 1 cun from these three acupoints. Subjects received acupressure thrice per week for 4 weeks, and pressure on each acupoint was applied for 3 min bilaterally. The primary outcome was fatigue severity, while sleep quality and psychological status (depression/anxiety) were evaluated as secondary outcomes. Outcomes were assessed using the Brief Fatigue Inventory, Pittsburgh Sleep Quality Index, and Hospital Anxiety and Depression Scale. Acupressure induced a significant medium to large effect on improvement in fatigue (b = -1.71, confidence interval [95% CI]: -1.90 to -1.51, ΔR² = 0.744), sleep quality (b = -5.81, 95% CI: -6.80 to -4.81, ΔR² = 0.525), and anxiety (Estimate = -3.213, 95% CI: -4.238 to -2.188, pseudo R² = 0.292)/depression (Estimate = -3.378, 95% CI: -4.432 to -2.325, pseudo R² = 0.268) in experimental group patients compared to controls. No adverse events of acupressure were reported during the study process. Acupressure significantly and independently improved fatigue, depression/anxiety, and sleep quality in ESRD patients receiving HD. NCT05571007.