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Post-dialysis fatigue predicts all-cause mortality in patients on chronic hemodialysis
Guy Watanabe1, Kenichi Tanaka1,2, Hirotaka Saito1
1Department of Nephrology and Hypertension, Fukushima Medical University, Fukushima, Japan.
Introduction:
Fatigue is reportedly associated with a poor prognosis in dialysis patients. The aim of the present study was to investigate whether fatigue on dialysis days or non-dialysis days is associated with mortality in patients on chronic hemodialysis.
Methods:
This was a prospective study of 134 hemodialysis patients. The level of fatigue was evaluated using a visual analog scale (VAS). The association between high fatigue evaluated by the highest quartile of the VAS value and all-cause death was investigated.
Results:
The fatigue scale score was significantly higher on dialysis than on non-dialysis days. During the follow-up period (median 6.8 years), 42 patients died. Patients with high post-dialysis fatigue in the higher quartiles died more frequently compared to those with in the lower quartiles (p = 0.012). Multivariate Cox regression analysis showed that high post-dialysis fatigue was an independent predictor of all-cause death (adjusted hazard ratio 2.12, 95% confidence interval 1.10-4.07).
Conclusion:
Higher post-dialysis fatigue is related to increased mortality.
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