title: Severe fatigue after kidney transplantation: a highly prevalent, disabling and multifactorial symptom.
abstract: 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.
authors: Expert Centre for Chronic Fatigue, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors: Martine M
authors: MM
authors: Goedendorp
authors: Andries J
authors: AJ
authors: Hoitsma
authors: Lotte
authors: L
authors: Bloot
authors: Gijs
authors: G
authors: Bleijenberg
authors: Hans
authors: H
authors: Knoop
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003404:Creatinine / Q000097:blood; D003863:Depression / Q000150:complications; D006233:Persons with Disabilities; D005221:Fatigue / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications; D011184:Postoperative Period; D015995:Prevalence; D011507:Proteinuria / Q000175:diagnosis; D011584:Psychology; D051437:Renal Insufficiency / Q000150:complications / Q000628:therapy*; D012720:Severity of Illness Index; D012944:Social Support; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D003404:Creatinine
keywords: creatinine; fatigue; functional impairments; kidney transplant recipients; proteinuria; psychosocial factors