BACKGROUND & AIMS:
:Fatigue is a common symptom of patients with chronic kidney disease, but seldom investigated after transplantation. We determined the prevalence, impact and related factors of severe fatigue in kidney transplant recipients (KTRs). Medical records and questionnaires were used to assess kidney function, donor characteristics, fatigue (Checklist Individual Strength), functional impairments (Sickness Impact Profile), work status, body mass index (BMI), pain, depressive symptoms, social support and sleeping problems in 180 participating KTRs. KTRs were compared with sex- and age-matched population-based controls. KTRs were significantly more often severely fatigued (39%) compared to matched controls (22%; P = 0.001). Severely fatigued KTRs had significantly more functional impairments than nonseverely fatigued recipients (effect size ≥ 0.7) P < 0.001, and less often a paid job (27% vs. 48%, P = 0.005). Univariate analysis showed that severely fatigued KTRs received more often a kidney from a deceased donor, had a higher BMI, more pain, discrepancy in social support, depressive symptoms and sleeping problems. In a multivariate analysis (n = 151) the latter two associations remained significant. Severe fatigue is a highly prevalent and disabling symptom in KTRs. Moreover, severe fatigue after kidney transplantation is more strongly related to behavioural and psychosocial factors than specific transplantation-related factors. Findings have implications for fatigue management.
背景与目标:
乏力是慢性肾脏疾病患者的常见症状,但移植后很少进行研究。我们确定了肾移植受者 (KTRs) 严重乏力的患病率,影响和相关因素。使用病历和问卷来评估肾功能,供体特征,乏力 (个人力量清单),功能障碍 (疾病影响特征),工作状态,体重指数 (BMI),疼痛,抑郁症状,社会支持和睡眠问题参加KTRs的180。将KTRs与性别和年龄匹配的基于人群的对照进行比较。与匹配的对照组 (22%; P = 0.001) 相比,ktr明显更经常严重疲劳 (39%)。严重疲劳的KTRs比非严重疲劳的接受者具有明显更多的功能障碍 (效应大小 ≥ 0.7) P <0.001,并且很少有报酬的工作 (27% 对48%,P = 0.005)。单变量分析显示,严重疲劳的KTRs更经常从已故捐赠者那里获得肾脏,BMI更高,疼痛更多,社会支持差异,抑郁症状和睡眠问题。在多变量分析 (n = 151) 中,后两种关联仍然显著。严重乏力是KTRs中非常普遍的致残症状。此外,与特定的移植相关因素相比,肾移植后的严重乏力与行为和社会心理因素的关系更为密切。研究结果对乏力管理有影响。