Post-dialysis fatigue in hemodialysis patients

Abstract

Post-dialysis fatigue (PDF) is a serious symptom that occurs specifically in hemodialysis patients and is accompanied by generalized weakness that lasts for several hours. According to a meta-analysis, PDF occurs at a rate of about 60％ among hemodialysis patients; however, many aspects of this entity are unknown, including factors and mechanisms, and no international guidelines have been established regarding factors and treatment or measurement methods. We developed a PDF self-assessment scale that showed reliability and validity. Factors associated with PDF include the cardiovascular effects of hemodialysis, laboratory abnormalities, and clinical factors. In clinical trials, dialysis techniques, treatment of depression, and exercise therapy have been reported to reduce PDF and fatigue. The further development of PDF treatment requires elucidation of the mechanism and risk factors of PDF as well as effective therapeutic interventions. For this purpose, a large-scale study using a unified measurement method is required.