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Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
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Assessing Fatigue in Patients Receiving Kidney Replacement Therapy Using PROMIS Computer Adaptive Testing.

Sumaya Dano1, Junayd Hussain2, Nathaniel Edwards1

  • 1Ajmera Transplant Center and Division of Nephrology, University Health Network, Toronto, Ontario.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|March 11, 2023
PubMed
Summary

The Patient Reported Outcome Measurement Information System (PROMIS)-Fatigue Computer Adaptive Test (PROMIS-F CAT) accurately measures fatigue in kidney replacement therapy patients. This tool offers robust measurement properties with a low burden for patients undergoing KRT.

Keywords:
Chronic kidney diseasefatiguekidney replacement therapypatient-reported outcomes

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Area of Science:

  • Nephrology
  • Patient-Reported Outcomes
  • Psychometrics

Background:

  • Fatigue is a common and debilitating symptom for patients undergoing kidney replacement therapy (KRT).
  • Accurate assessment of fatigue is crucial for effective patient management.
  • Patient-reported outcome measures (PROMs) aid in identifying and managing patient fatigue.

Purpose of the Study:

  • To evaluate the measurement characteristics of the PROMIS-Fatigue Computer Adaptive Test (PROMIS-F CAT) in patients receiving KRT.
  • To compare the PROMIS-F CAT with the established Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) questionnaire.

Main Methods:

  • A cross-sectional study was conducted with 198 adults receiving dialysis or kidney transplants in Toronto, Canada.
  • Measurement properties including reliability, test-retest reliability, and construct validity of PROMIS-F CAT were assessed.
  • Receiver operating characteristic (ROC) curves were used to evaluate the discrimination of PROMIS-F CAT against the FACIT-F.

Main Results:

  • PROMIS-F CAT demonstrated strong correlation with FACIT-F (ρ = -0.80, P<0.001).
  • Excellent reliability (>0.90) and good test-retest reliability (ICC=0.85) were observed for PROMIS-F CAT.
  • ROC analysis showed outstanding discrimination (AUC=0.93), with a PROMIS-F CAT cutoff of ≥59 accurately identifying clinically relevant fatigue.

Conclusions:

  • The PROMIS-F CAT exhibits robust measurement properties for assessing fatigue in KRT patients.
  • The PROMIS-F CAT offers a low question burden, enhancing its utility in clinical settings.
  • This validated tool can efficiently identify and manage fatigue in individuals with kidney replacement therapy.