Prevalence and Severity of Postdialysis Fatigue Are Higher in Patients on Chronic Hemodialysis With Functional Disability

The aim of the present study was to deter-mine the intensity, duration, frequency and prevalence ofpostdialysis fatigue (PDF) in patients on chronic hemodialy-sis (PCD) with and without functional disability. Patientsunderwent assessment of functional ability by the KatzADL (activity daily living) questionnaire and the Lawtonand Brody scale for the instrumental activity daily living(IADL) fatigue using the SF-36 Vitality Subscale, comorbid-ity through the Charlson comorbidity score index (CDI),and time of recovery after hemodialysis (TIRD). We stud-ied 271 PCD. ADL and IADL disabilities were present in75 (27.6%) and 168 (62%) patients, respectively. Patientswith ADL disability were significantly older and showedhigher CDI scores, and lower levels of serum albumin andKt/V. Prevalence of PDF was significantly higher in patientswith ADL disability as well as its severity, intensity,duration and frequency. Patients with IADL disability weresignificantly older, had a higher CCI score, had lower levelsof serum albumin and Kt/V, and had a higher severity,intensity, duration and frequency of PDF. At multivariateregression analysis, ADL disability was positively associatedwith age, prevalence and severity of PDF, and dialysatetemperature and inversely associated with serum albuminlevels. IADL disability was instead positively associatedwith age and dialysate temperature and inversely associatedwith serum albumin levels. In conclusion, prevalence andseverity of PDF are significantly higher in PCD with ADLdisability than in those without it. This knowledge may haveimportant implications for the development of interventionsto reduce PDF in PCD.