Abstract: FR-PO1046
The FADSS Constellation: Fatigue, Affective Disorders, Sleep, and Sarcopenia Syndrome Assessment in Patients on Hemodialysis
Session Information
- Hemodialysis: Clinical Challenges, Patient-Centered Outcomes, and Quality of Life
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Upadhyay, Rutansh, MP Shah Medical College, Jamnagar, GJ, India
- Vachhani, Parthiv Manishbhai, MP Shah Medical College, Jamnagar, GJ, India
- Agrawal, Shaily Maheshkumar, MP Shah Medical College, Jamnagar, GJ, India
- Nagda, Jay Jayantilal, MP Shah Medical College, Jamnagar, GJ, India
Background
Patients on maintenance hemodialysis (MHD) carry a multidimensional symptom burden—fatigue, affective disorders, sleep disturbance, sarcopenia—each predicting adverse outcomes yet rarely characterized as an integrated complex with metabolic determinants.
Methods
In this cross-sectional study (September 2025–February 2026), 158 adults on MHD ≥3 months at a tertiary center in western India were enrolled. Fatigue, depression, and sleep were quantified using the Fatigue Severity Scale, PHQ-9 and Pittsburgh Sleep Quality Index; sarcopenia was ascertained as per AWGS-2019. Covariates included Charlson comorbidity index, serum creatinine, iron, and intact parathyroid hormone (iPTH). Independent predictors were identified by multivariable logistic regression.
Results
Poor sleep quality predominated (70.25%), followed by anxiety (41.77%), sarcopenia (30.37%), fatigue (25.3%) and depressive symptoms (17.72%). Sarcopenia showed a steep age-dependent gradient (15.4% at 30–39 years to 72.7% at ≥70 years) with threefold excess depression (29.2% vs 8.6%). In adjusted models (Figure 1), fatigue was independently predicted by higher dialysis frequency and suppressed iPTH (AOR 4.20); anxiety by low serum creatinine (AOR 2.34), with 1–5-year dialysis vintage protective; and poor sleep by iron deficiency (AOR 3.61). Sarcopenia was driven primarily by anemia (AOR 11.69, 95% CI 2.19–62.37); iPTH within KDIGO target and intermediate vintage each conferred protection. Depression had no independent predictor after adjustment.
Conclusion
Patients on MHD exhibit a coherent FADSS symptom constellation underpinned by distinct yet overlapping mechanistic axes—CKD-MBD, malnutrition-inflammation, iron dysregulation, erythropoietic failure—warranting mechanistically targeted intervention (anemia correction, iron repletion, KDIGO-aligned iPTH stewardship, structured exercise) as standard hemodialysis care.
Figure 1: Forest plot of Adjusted odds ratios (AOR, 95% CI) from multivariable logistic regression models across the four FADSS symptom domains.
Funding
- Government Support – Non-U.S.