Factors related to fatigue and subgroups of fatigue in patients with end-stage renal disease

Introduction and aims: Fatigue is a major determinant for quality of life for patients undergoing chronic hemodialysis (HD) treatment. The aim of this study was to determine the severity and contributing factors of fatigue in patients under chronic HD treatment. Methods: 154 end-stage renal disease (ESRD) patients under HD treatment (92 M, 62 F, mean age 53 +/- 15 y, mean duration of HD treatment 92 +/- 65 months) were enrolled. Patients were given Piper's fatigue scale (PFS), Epworth sleepiness scale (ESS) and Beck depression test (BDT). Study participants were evaluated at the end of the HD session. Results: ESS score was above 10 (indicating daytime sleepiness) in only 6 (3.9%) patients. The overall PFS scores were normal-to-mild in 25 (16.2%), moderate in 63 (40.9%) and severe in 66 (42.9%) patients. Total PFS score was correlated with presence of depression (OR: 2.48), employment status (OR: 2.25), calcium (OR: 2.64) and phosphate (OR: 3.70) concentration. PFS behavior score was correlated with employment status (OR: 2.29) and phosphate (OR: 1.96). PFS affective score was correlated with presence of depression (OR: 2.56), employment status (OR: 2.72) and creatinine (OR: 2.25) concentration. PFS sensory score was correlated with advanced age (OR: 1.95), presence of depression (OR: 2.90), albumin (nutritional status) (OR: 0.17), postdialysis serum urea level (OR: 2.37), hemoglobin (anemia) (OR: 0.21). Conclusion: Daytime sleepiness is not prevalent; however, fatigue is closely related to presence of depression, employment status, and calcium and phosphate levels.