Prevalence of post-dialysis fatigue: a systematic review and meta-analysis

OBJECTIVES: The purpose of this study was to synthesise data on the prevalence of post-dialysis fatigue (PDF) among haemodialysis (HD) patients. DESIGN: Systematic review and meta-analysis. DATA SOURCES: China National Knowledge Infrastructure, Wanfang, Chinese Biological Medical Database, PubMed, EMBASE and Web of Science were searched from their inception to 1 April 2022. ELIGIBILITY CRITERIA: We selected patients who must receive HD treatment for at least 3 months. Cross-sectional or cohort studies published in Chinese or English were eligible for inclusion. The main search terms used in the abstract were: “renal dialysis”, “hemodialysis” and “post-dialysis”, in combination with the word “fatigue”. DATA EXTRACTION AND SYNTHESIS: Two investigators independently performed data extraction and quality assessment. Data were pooled to estimate the overall prevalence of PDF among HD patients using the random-effects model. Cochran’s Q and I(2) statistics were adopted to evaluate heterogeneity. RESULT: A total of 12 studies were included, with 2152 HD patients, of which 1215 were defined as having PDF. The overall prevalence of PDF in HD patients was 61.0% (95% CI: 53.6% to 68.3%, p<0.001, I(2)=90.0%). Subgroup analysis failed to explain the source of heterogeneity, but univariable meta-regression showed that a mean age of ≥50 years might be the source of heterogeneity. Egger’s test revealed no publication bias among the studies (p=0.144). CONCLUSIONS: PDF is highly prevalent among HD patients.