Chronic Fatigue in Long-term Peritoneal Dialysis Patients

長期腹膜透析病人的慢性疲勞症

張維廣(W. K. Chang) ； 洪冠予(K. Y. Hung) ； 黃政文(J. W. Huang) ； 吳寬墩(K. D. Wu) ； 蔡敦仁(T. J. Tsai)

《Acta Nephrologica》 14卷4期 (2000/10) Pp. 265-265

並列摘要

Objective: Fatigue is a common symptom in long-term dialysis patients. This study investigated possible clinical factors which may cause the development of fatigue in patients receiving peritoneal dialysis (PD). We also investigated the relationship between total solute clearance (TSC) and fatigue symptoms in PD patients.
Design: A cross-sectional study design was used to compare the clinical characteristics among groups of PD patients classified by different degrees of fatigue. The relationship among dialysis adequacy (including Kt/Vurea and weekly creatinine clearance), clinical characteristics and fatigue symptoms were also assessed.
Patients: Consecutive patients who had received PD for a minimum duration of 4 months were recruited for participation in the study. Patients were excluded if they had a history of ischemic heart disease, severe heart failure (NYHA function III or IV), malignant neoplasm, active infection, major psychiatric problems, chronic obstructive pulmonary disease, or disturbed consciousness. Finally, a total of 64 patients, 31 of whom were receiving continuous ambulatory peritoneal dialysis (CAPD) and 33 who were receiving continuous cycling-assisted peritoneal dialysis (CCPD), were enrolled in the study.
Methods: Fatigue was evaluated using a specially designed questionnaire that includes fourteen items. According to their fatigue scores (FS), patients were divided into mild (FS,0-3), moderate (FS,4-8), and severe (FS,9-14)groups. The demographic data, dialysis variables, and clinical parameters of patients were compared among these groups. The relationship between fatigue and TSC was also examined.
Results: The FS were correlated with serum intact parathyroid hormone (iPTH) level and total cholesterol concentration (p＜0.05). A linear correlation was also noted between serum iPTH level and total cholesterol level. When the patients were divided into adequate and inadequate group according to values of TSC, Kt/Vurea as well as weekly creatinine clearance, a significant correlation was found between weekly Ccr and fatigue scores.
Conclusion: This study has demonstrated that dialysis plays a key role in the development chronic fatigue. In addition, weekly Ccr was better correlated with fatigue than Kt/Vurea.