title: Factors related to fatigue in Chinese patients with end-stage renal disease receiving maintenance hemodialysis: a multi-center cross-sectional study.
abstract: BACKGROUND
  Fatigue is considered as a common symptom in patients with end-stage renal disease (ESRD) and can significantly decrease patients' quality of life. This study aimed to assess fatigue in hemodialysis patients and to investigate risk factors of fatigue in Chinese patients receiving maintenance hemodialysis (MHD) in China.
  
  
  METHODS
  Eligible patients completed questionnaires including demographic information, a Chinese version of the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue), the Family APGAR Index (APGAR), the medical outcomes study health status-Social Functioning subscale (SF-36,SocF), and the Pittsburgh sleep quality index (PSQI). Laboratory parameters were abstracted by medical records review. The multiple linear regression model was used to relate parameters with the FACIT-Fatigue score.
  
  
  RESULTS
  A total of 345 MHD patients (216 men and 129 women, age 55.6 ± 12.8) were recruited in this study. The score of FACIT-Fatigue was 39 (Interquartile Range, 31-44). Fatigue was correlated with PSQI scores (p < 0.001), SocF scores (p < 0.001), comorbidity (p = 0.006), exercise time <1 hour per day (p = 0.003), adequacy of dialysis (Kt/V) < 1.2 (p = 0.016), APGAR scores (p = 0.014), and high Scr (p = 0.043).
  
  
  CONCLUSIONS
  Fatigue is related to sleep disturbance, social and family functioning, taking physical exercise time, comorbidity condition, Kt/V and serum creatinine level in Chinese MHD patients. Future studies and interventions should focus on developing strategies and improving the quality of life in patients by addressing these significant contributing factors.
authors.affiliation: a School of Nursing , Tianjin Medical University , Tianjin , China ;
authors.forename: Si-Yuan
authors.initials: SY
authors.lastname: Wang
authors.affiliation: a School of Nursing , Tianjin Medical University , Tianjin , China ;
authors.forename: Xiao-Ying
authors.initials: XY
authors.lastname: Zang
authors.affiliation: b Organ Transplant Center , Tianjin Medical University General Hospital , Tianjin , China ;
authors.forename: Sheng-Hui
authors.initials: SH
authors.lastname: Fu
authors.affiliation: c School of Nursing , the University of North Carolina at Chapel Hill , Chapel Hill , NC , USA ;
authors.forename: Jinbing
authors.initials: J
authors.lastname: Bai
authors.affiliation: d Organ Transplant Center , Tianjin First Center Hospital , Tianjin , China ;
authors.forename: Jun-Duo
authors.initials: JD
authors.lastname: Liu
authors.affiliation: e Department of Nursing , Tianjin Third Center Hospital , Tianjin , China ;
authors.forename: Li
authors.initials: L
authors.lastname: Tian
authors.affiliation: f Organ Transplant Center , Tianjin Third Center Hospital , Tianjin , China.
authors.forename: Yu-Ying
authors.initials: YY
authors.lastname: Feng
authors.affiliation: a School of Nursing , Tianjin Medical University , Tianjin , China ;
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000150:complications; D002681:China; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications; D005221:Fatigue / Q000150:complications*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life; D006435:Renal Dialysis / Q000009:adverse effects* / Q000523:psychology*; D012893:Sleep Wake Disorders / Q000150:complications; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers
keywords: Exercise; family functioning; fatigue; hemodialysis; sleep problem; social functioning