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Abstract: PO0801

Fatigue Prevalence and Associations with Non-Diuretic Anti-Hypertensive Medications in the Maintenance Hemodialysis Population

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Derk, Gwendolyn, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
  • Barton, Amy, Vifor Pharma Ltd, Glattbrugg, Zurich, Switzerland
  • Wilund, Kenneth Robert, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States

Group or Team Name

  • Renal and Cardiovascular Disease Research Laboratory
Background

It is well known that dialysis patients suffer from fatigue post dialysis. It is possible that fatigue is exacerbated by antihypertensive medications. We hypothesized that post-dialysis fatigue (PDF) duration was positively correlated with the number of antihypertensive medications.

Methods

We conducted cross sectional survey and 6 month retrospective medical record chart review at three privately owned dialysis clinics in Illinois. The survey consists of 50 questions related to fluid and blood pressure management, the validated Post-Dialysis Fatigue and Time to Recover from Dialysis Survey (PDF TIRD), and the validated National Institute of Health Patient Reported Outcomes Measurement System fatigue short form. A random mixed effect model was created through a reverse stepwise process in order to assess associations. Chi-squared analysis was performed with categorical symptom data.

Results

One hundred and two patients consented to the study, 96 had complete medical records with all research variables and survey values captured. The average number of dialysis sessions captured per patient was 50.0 +/- 19. The average time on maintenance hemodialysis was 5.06 +/- 4.93 years with a range of 0.2 to 28 years. Seventy six percent (73/96) of dialysis patients suffered from post-dialysis fatigue. Most patients 53/96 reported that their fatigue was the worst after dialysis. On average patients required 462.67 +/- 655.18 minutes (7.7 +/- 10.92 hours) to recover after dialysis. In our random mixed effect model, the time required to recover post-dialysis was positively associated with the number of non-diuretic antihypertensive medications: For every anti-hypertensive medication, patients experienced an additional 210 minutes (3.5 hrs) of fatigue post dialysis fatigue.

Conclusion

Post-dialysis fatigue is a pervasive problem in the dialysis population that has significant consequences on patients’ quality of life. While fatigue has several important contributing factors, the number of non-diuretic blood pressure medications appear to exacerbate patients’ fatigue. Further investigation on the survival and quality of life benefits, including fatigue, of patients maintained on antihypertensive medications versus volume control strategies is needed.