Dialysis recovery time: associated factors and its association with quality of life of hemodialysis patients

Mohamed Mamdouh Elsayed, Montasser Mohamed Zeid, Osama Mohamed Refai Hamza, Noha Mohamed Elkholy, Mohamed Mamdouh Elsayed, Montasser Mohamed Zeid, Osama Mohamed Refai Hamza, Noha Mohamed Elkholy

Abstract

Introduction: Post-dialysis fatigue is a common and distressing complaint in patients on hemodialysis (HD). The dialysis recovery time (DRT) is a recent and reliable method of Post-dialysis fatigue assessment. We aimed to identify factors affecting the DRT and its relation with HD patients' quality of life.

Material and methods: This is a cross-sectional study carried out on end-stage renal disease patients on regular HD. All participants underwent detailed history taking and complete physical examination, and data on dialysis and laboratory investigations were also collected. Patients were asked "How long does it take you to recover from a dialysis session?" to calculate the DRT. We used the Malnutrition-Inflammation Score (MIS) and KDQOL-36 questionnaire to assess patients' nutritional status and quality of life, respectively.

Results: Two hundred and ten patients were screened and 191, with a median age of 47 years, completed the study. Patients had a median DRT of 300 minutes (range: 0.0-2880.0), with 55% of patients reporting a DRT of > 240 minutes and 22.5% of them reporting a DRT of < 30 minutes. Patients had a median MIS score of 7 (range: 0-17). There was a statistically significant negative relation between the DRT and symptom/ problem list (p < 0.001), effects of kidney disease (p < 0.001), burden of kidney disease (p < 0.001), SF-12 physical composite (p = 0.001), and SF-12 mental composite (p < 0.001) of KDQOL. The results of multivariate analyses showed that dialysate Na (p = 0.003), and the number of missed sessions (p < 0.001) were independently correlated with the DRT.

Conclusions: Decreased dialysate Na, and increased number of missed sessions were predictors of prolonged DRT. Patients with prolonged DRT were associated with poorer quality of life. Further randomized clinical trials are needed to assess strategies to minimize the DRT and, perhaps, enhance clinical outcomes.

Trials registration: ClinicalTrials.gov Identifier: NCT04727281. First registration date: 27/01/2021.

Keywords: Dialysis recovery time; Hemodialysis; Malnutrition; Quality of life.

Conflict of interest statement

The authors declare that they have no conflicts of interest.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Associations between the DRT and sex, heart failure, and hemodialysis schedule. a Relation between DRT with sex. b Relation between DRT with heart failure. c Relation between DRT with hemodialysis schedule

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