Cargando…
Intradialytic Symptoms and Recovery Time in Patients on Thrice-Weekly In-Center Hemodialysis: A Cross-sectional Online Survey
RATIONALE & OBJECTIVE: Patients experience various symptoms during hemodialysis. We aimed to assess the frequency and severity of symptoms during hemodialysis and whether intradialytic symptoms are associated with recovery time postdialysis. STUDY DESIGN: An online questionnaire was sent to 10,0...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7380355/ https://www.ncbi.nlm.nih.gov/pubmed/32734233 http://dx.doi.org/10.1016/j.xkme.2019.10.010 |
_version_ | 1783562837261549568 |
---|---|
author | Alvarez, Luis Brown, Deborah Hu, Dean Chertow, Glenn M. Vassalotti, Joseph A. Prichard, Sarah |
author_facet | Alvarez, Luis Brown, Deborah Hu, Dean Chertow, Glenn M. Vassalotti, Joseph A. Prichard, Sarah |
author_sort | Alvarez, Luis |
collection | PubMed |
description | RATIONALE & OBJECTIVE: Patients experience various symptoms during hemodialysis. We aimed to assess the frequency and severity of symptoms during hemodialysis and whether intradialytic symptoms are associated with recovery time postdialysis. STUDY DESIGN: An online questionnaire was sent to 10,000 patients in a National Kidney Foundation database. SETTING & PARTICIPANTS: Adult patients receiving in-center hemodialysis 3 times weekly for 3 or more months. EXPOSURE: Online questionnaire. ANALYTIC APPROACH: Tabulation of frequency and severity of events and recovery time as percent of respondents, construction of a total symptom score, followed by rank correlation analysis of symptom characteristics with total recovery time. OUTCOMES: Patient-reported intradialytic symptoms and recovery time postdialysis. RESULTS: 359 patients met screening criteria and completed the questionnaire. Mean age was 62.5 ± 13.8 years, 207 (58%) were men, 74 (21%) were black/African American, 132 (37%) had diabetes, 252 (70%) had hypertension, and 102 (28%) had a history of myocardial infarction, heart surgery, or stent placement. 311 (87%) patients had symptoms during dialysis in the previous week, with mean severity of 2.7 (range for each symptom, 1-5). The most common symptoms were fatigue/feeling washed out (62%), cramps (44%), and symptoms of low blood pressure (42%). Median time to recovery was 3 (range, 0-24) hours, and this correlated with the incidence and severity of intradialytic symptoms (P < 0.0001). 40% of patients had time to recovery times of 4 hours or longer. 1 in 3 patients reported having stopped dialysis early for intradialytic symptoms and 6% reported skipping dialysis at least once because of intradialytic symptoms. LIMITATIONS: Recall-based self-reported data with a relatively low response rate. CONCLUSIONS: A majority of patients receiving in-center hemodialysis experience symptoms such as feeling washed out, fatigue, and cramping; these may be severe and are correlated with longer recovery time following hemodialysis, as well as shortened and skipped hemodialysis sessions. |
format | Online Article Text |
id | pubmed-7380355 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-73803552020-07-29 Intradialytic Symptoms and Recovery Time in Patients on Thrice-Weekly In-Center Hemodialysis: A Cross-sectional Online Survey Alvarez, Luis Brown, Deborah Hu, Dean Chertow, Glenn M. Vassalotti, Joseph A. Prichard, Sarah Kidney Med Original Research RATIONALE & OBJECTIVE: Patients experience various symptoms during hemodialysis. We aimed to assess the frequency and severity of symptoms during hemodialysis and whether intradialytic symptoms are associated with recovery time postdialysis. STUDY DESIGN: An online questionnaire was sent to 10,000 patients in a National Kidney Foundation database. SETTING & PARTICIPANTS: Adult patients receiving in-center hemodialysis 3 times weekly for 3 or more months. EXPOSURE: Online questionnaire. ANALYTIC APPROACH: Tabulation of frequency and severity of events and recovery time as percent of respondents, construction of a total symptom score, followed by rank correlation analysis of symptom characteristics with total recovery time. OUTCOMES: Patient-reported intradialytic symptoms and recovery time postdialysis. RESULTS: 359 patients met screening criteria and completed the questionnaire. Mean age was 62.5 ± 13.8 years, 207 (58%) were men, 74 (21%) were black/African American, 132 (37%) had diabetes, 252 (70%) had hypertension, and 102 (28%) had a history of myocardial infarction, heart surgery, or stent placement. 311 (87%) patients had symptoms during dialysis in the previous week, with mean severity of 2.7 (range for each symptom, 1-5). The most common symptoms were fatigue/feeling washed out (62%), cramps (44%), and symptoms of low blood pressure (42%). Median time to recovery was 3 (range, 0-24) hours, and this correlated with the incidence and severity of intradialytic symptoms (P < 0.0001). 40% of patients had time to recovery times of 4 hours or longer. 1 in 3 patients reported having stopped dialysis early for intradialytic symptoms and 6% reported skipping dialysis at least once because of intradialytic symptoms. LIMITATIONS: Recall-based self-reported data with a relatively low response rate. CONCLUSIONS: A majority of patients receiving in-center hemodialysis experience symptoms such as feeling washed out, fatigue, and cramping; these may be severe and are correlated with longer recovery time following hemodialysis, as well as shortened and skipped hemodialysis sessions. Elsevier 2019-12-20 /pmc/articles/PMC7380355/ /pubmed/32734233 http://dx.doi.org/10.1016/j.xkme.2019.10.010 Text en © 2019 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Research Alvarez, Luis Brown, Deborah Hu, Dean Chertow, Glenn M. Vassalotti, Joseph A. Prichard, Sarah Intradialytic Symptoms and Recovery Time in Patients on Thrice-Weekly In-Center Hemodialysis: A Cross-sectional Online Survey |
title | Intradialytic Symptoms and Recovery Time in Patients on Thrice-Weekly In-Center Hemodialysis: A Cross-sectional Online Survey |
title_full | Intradialytic Symptoms and Recovery Time in Patients on Thrice-Weekly In-Center Hemodialysis: A Cross-sectional Online Survey |
title_fullStr | Intradialytic Symptoms and Recovery Time in Patients on Thrice-Weekly In-Center Hemodialysis: A Cross-sectional Online Survey |
title_full_unstemmed | Intradialytic Symptoms and Recovery Time in Patients on Thrice-Weekly In-Center Hemodialysis: A Cross-sectional Online Survey |
title_short | Intradialytic Symptoms and Recovery Time in Patients on Thrice-Weekly In-Center Hemodialysis: A Cross-sectional Online Survey |
title_sort | intradialytic symptoms and recovery time in patients on thrice-weekly in-center hemodialysis: a cross-sectional online survey |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7380355/ https://www.ncbi.nlm.nih.gov/pubmed/32734233 http://dx.doi.org/10.1016/j.xkme.2019.10.010 |
work_keys_str_mv | AT alvarezluis intradialyticsymptomsandrecoverytimeinpatientsonthriceweeklyincenterhemodialysisacrosssectionalonlinesurvey AT browndeborah intradialyticsymptomsandrecoverytimeinpatientsonthriceweeklyincenterhemodialysisacrosssectionalonlinesurvey AT hudean intradialyticsymptomsandrecoverytimeinpatientsonthriceweeklyincenterhemodialysisacrosssectionalonlinesurvey AT chertowglennm intradialyticsymptomsandrecoverytimeinpatientsonthriceweeklyincenterhemodialysisacrosssectionalonlinesurvey AT vassalottijosepha intradialyticsymptomsandrecoverytimeinpatientsonthriceweeklyincenterhemodialysisacrosssectionalonlinesurvey AT prichardsarah intradialyticsymptomsandrecoverytimeinpatientsonthriceweeklyincenterhemodialysisacrosssectionalonlinesurvey |