Abstract:
BACKGROUND:Fatigue is an important symptom to patients with advanced chronic kidney disease (CKD). The aim of this study is to examine the prevalence and severity of fatigue among non-dialysis-dependent CKD and end-stage renal disease (ESRD) patients, to examine the association of fatigue with subjective and objective sleep quality, and to identify other modifiable factors associated with fatigue. METHODS:A cross-sectional survey of 87 non-dialysis-dependent CKD (eGFR ≤45 ml/min/1.73 m(2)) and 86 ESRD patients was done using the Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) and 36-Item Short-Form (SF-36) vitality scale. Higher FACIT-F score denoted less fatigue. Objective sleep was assessed using in-home polysomnography. Predictors of fatigue were determined using a linear regression model. RESULTS:The mean FACIT-F score among all participants was 34.5 ± 11.0. Mean scores were similar among CKD and ESRD groups (34.25 ± 11.28 vs. 34.73 ± 10.86; p = 0.73). On univariate analyses, patients with higher levels of fatigue were more likely to have cardiovascular disease, benzodiazepine use, depressive symptoms, and slightly lower hemoglobin and serum albumin levels. There was no significant association between severity of sleep apnea and level of fatigue (Apnea Hypopnea Index 20.1 ± 27.6 vs. 20.3 ± 22.0; p = 0.69). Presence of cardiovascular disease, low serum albumin, depressive symptoms, poor subjective sleep quality, excessive daytime sleepiness and restless legs syndrome were independently associated with greater fatigue in multivariable regression models. The FACIT-F score correlated closely with the SF-36 vitality score (r = 0.81, p < 0.0001). CONCLUSIONS:Patients with advanced CKD and ESRD experience profound fatigue. Depressive symptoms, restless legs syndrome, excessive daytime sleepiness, and low albumin levels may provide targets for interventions to improve fatigue in patients with advanced CKD.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Jhamb M,Liang K,Yabes J,Steel JL,Dew MA,Shah N,Unruh Mdoi
10.1159/000356939subject
Has Abstractpub_date
2013-01-01 00:00:00pages
489-95issue
6eissn
0250-8095issn
1421-9670pii
000356939journal_volume
38pub_type
杂志文章abstract:BACKGROUND:Published reports examining the efficacy and safety of glucocorticoids for preserving renal function in immunoglobulin A nephropathy (IgAN) have yielded conflicting results. To systematically evaluate the efficacy and safety of glucocorticoids agents for IgAN, we conducted a meta-analysis of the published ra...
journal_title:American journal of nephrology
pub_type: 杂志文章,meta分析,评审
doi:10.1159/000226129
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND/AIM:Slc26a6 (PAT1, CFEX) is a major chloride/base exchanger located on the apical membrane of the kidney proximal tubule. The purpose of the present study was to examine the effect of Slc26a6 deletion on the apical Na+/H+ exchanger 3 (NHE3) in the straight segment (S3) of the proximal tubule, which is the ma...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000111826
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Data concerning long-term mortality predictors among large, purely diabetic hemodialysis collectives are scarce. METHODS:We used data from a multicenter, prospective, randomized trial among 1,255 hemodialysis patients with type 2 diabetes mellitus (T2DM) and its observational follow-up study. The associatio...
journal_title:American journal of nephrology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1159/000485842
更新日期:2018-01-01 00:00:00
abstract::One hundred twenty-eight hemodialysis patients and 64 medical personnel consisting of dialysis nurses and technicians, hemodialysis access surgeons and nephrologists were surveyed about their preferences and concerns in regard to the hemodialysis vascular access. The access preferred by physicians was the A-V fistula ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013380
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Treatment of metabolic acidosis to target the higher serum bicarbonate level than guideline recommendation may downregulate muscle protein degradation and improve renal function among chronic kidney disease (CKD) patients. We conducted a study to test the effects of increased serum bicarbonate level on muscl...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000504557
更新日期:2020-01-01 00:00:00
abstract::Atherosclerotic diseases (ASD) are the major cause of mortality and morbidity in patients on hemodialysis (HD). To evaluate the significance and usefulness of atherogenic indices, we examined lipoprotein(a) (Lp(a)), remnant-like particles cholesterol (RLP.C), homocysteine (Hcy), cardiac troponin T (TnT), and ankle-arm...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000013566
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Steroid therapy has become an effective option for patients with primary Sjogren's syndrome with tubulointerstitial nephritis (TIN), while the use of cytotoxic agents is still debated. Our study aimed to compare the clinical outcomes of patients treated with cyclophosphamide (CTX) combined with glucocorticoi...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000484903
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Estimating total body water (TBW) is crucial in determining dry weight and dialytic dose for hemodialysis patients. Several anthropometric equations have been used to predict TBW, but a more accurate method is needed. We developed an artificial neural network (ANN) to predict TBW in hemodialysis patients. M...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000088279
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND/AIMS:HFE protein controls iron absorption and cycling, and HFE mutations influence iron status. The aim was to evaluate the effect of the HFE genotype on the need for iron and erythropoietin in Italian hemodialysis patients. METHODS:Ninety-six prevalent patients were evaluated at the time of enrolment and p...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000111387
更新日期:2008-01-01 00:00:00
abstract:PURPOSE:To explore the association between CYP3A4 and CYP3A5 gene polymorphisms and blood pressure response to amlodipine among participants from the African-American Study of Kidney Disease and Hypertension Trial randomized to amlodipine (n = 164). METHODS:Cox proportional hazards models were used to determine the ri...
journal_title:American journal of nephrology
pub_type: 杂志文章,随机对照试验
doi:10.1159/000258688
更新日期:2010-01-01 00:00:00
abstract::We studied plasma, dialysate, and muscle carnitine levels in patients with stable chronic renal failure on hemodialysis, and intermittent peritoneal, or continuous ambulatory peritoneal dialysis (CAPD). In patients on hemodialysis, plasma carnitine levels fell from 46.2 +/- 4.5 mumol/l (mean +/- SEM) to 18.8 +/- 2.7 m...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000166711
更新日期:1983-07-01 00:00:00
abstract::Therapeutic use of D-penicillamine has been associated with a range of adverse effects. We present a patient with scleroderma, treated with D-penicillamine for 5 years, who developed severe renal failure due to rapidly progressive glomerulonephritis with both crescents and subepithelial immune deposits on renal biopsy...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000169183
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Contemporary prevalence of chronic kidney disease (CKD) and thrombotic cardiovascular (CV) events remains unclear in Veterans enrolled in the Veterans Affairs Health Care System (VA) care. Although oral P2Y12 inhibitors (P2Y12i) are increasingly being prescribed to this patient population, the overall prescr...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000486647
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Hepcidin synthesis in hepatocytes is modulated in response to anemia, hypoxia or inflammation. A cross-sectional study was performed to assess hepcidin correlations with markers of iron status, erythropoietin therapy and markers of inflammation in hemodialyzed patients and in the healthy volunteers. METHODS...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000089266
更新日期:2005-11-01 00:00:00
abstract::Alcaligenes xylosoxidans is an uncommon cause of peritonitis in patients on maintenance continuous ambulatory peritoneal dialysis (CAPD). Peritonitis caused by A. xylosoxidans usually carries a poor prognosis because of the pathogen's virulence and its universal resistance to most antimicrobial agents. Even after earl...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000046657
更新日期:2001-11-01 00:00:00
abstract::We have compared the renal effects of ioxitalamate, ioxaglate, and iopamidol in patients with chronic renal failure. Sixty consecutive patients with an estimated creatinine clearance (ECRCl) less than 60 ml/min were randomly assigned to receive either ioxitalamate, iopamidol, or ioxaglate. All patients received 500 cm...
journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000168328
更新日期:1991-01-01 00:00:00
abstract::Angiotensin-converting enzyme (ACE) inhibitor therapy has recently been shown to be effective in the treatment of post-renal transplant erythrocytosis (PTE). In an attempt to assess the effect of drug treatment on serum erythropoietin level, glomerular filtration rate, and urinary protein excretion, we prospectively e...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168856
更新日期:1995-01-01 00:00:00
abstract::The acid-base balance of 199 patients with cystic fibrosis, seen from 1987 through 1992 at the Bern Outpatient Clinic, were evaluated. Simple metabolic alkalosis was demonstrated in 16 and mixed metabolic alkalosis and respiratory acidosis in 9 patients. When compared with 10 patients with simple respiratory acidosis ...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168839
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Serum protein profiling patterns can reflect the pathological state of a patient and therefore may be useful for clinical diagnostics. Here, we present results from a pilot study of proteomic expression patterns in hemodialysis patients designed to evaluate the range of serum proteomic alterations in this po...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000077409
更新日期:2004-03-01 00:00:00
abstract::A patient with progressive systemic sclerosis (PSS) involving skin, digit, esophagus, and lung developed the nephrotic syndrome and rapidly progressive renal insufficiency. Renal pathology revealed capillary collapse, cellular crescents, arteriolar hyaline deposition, and mesangial proliferation. On immunofluorescence...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000167055
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND/AIMS:The elderly are the fastest growing subpopulation with end-stage renal disease. The goal of our study was to define characteristics of elderly patients who were considered ineligible for transplantation compared to those who were listed. METHODS:984 patients were referred for evaluation during a 2-year...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000354483
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Chronic metabolic acidosis is a common metabolic disturbance and its clinical impact can be severe and extensive. The role and the change of the intrarenal renin-angiotensin system (RAS) during metabolic acidosis are uncertain, and whether acidosis can evoke inflammation remains unclear. METHODS:Male Spragu...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000328742
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) is increasingly common and disproportionately affects older adults. The contribution of kidney disease to the functional impairment noted in the elderly CKD population is unclear. METHODS:This is a cross-sectional analysis of a hypertensive cohort of people aged ≥75 years from t...
journal_title:American journal of nephrology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1159/000455388
更新日期:2017-01-01 00:00:00
abstract::To determine the prevalence and type of glomerulonephritis (GN) associated with hepatitis C virus (HCV) cirrhosis, we prospectively evaluated 28 consecutive Saudi patients with HCV cirrhosis for liver transplantation. Six patients (21%) underwent kidney biopsies for proteinuria, unexplained elevated serum creatinine o...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000168874
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Patients with chronic kidney disease (CKD) show increased cardiovascular morbidity. We hypothesized that vascular properties which can be routinely evaluated noninvasively are related to different stages of CKD and their clinical and biochemical characteristics. METHODS:Arterial vascular properties were qua...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000110091
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND/AIMS:We examined the correlations between renal biopsy findings in Wegener's granulomatosis and renal function at baseline and 1 year in 22 patients who presented between 1988 and 1999. METHODS:Renal histology was independently reviewed by 2 pathologists who were masked to the clinical data. The primary out...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000065283
更新日期:2002-09-01 00:00:00
abstract:AIMS:Although there are plenty of data about the differences in left ventricular tissue Doppler (TD) velocities by preload reduction, only a few studies regarding right ventricular function are found in the literature. We investigated the effect of intravascular volume reduction on right ventricular function by ultrafi...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000086080
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND/AIMS:Patients on chronic hemodialysis have a high prevalence of heart disease and poor self-reported physical function. The association between structural heart disease and self-reported physical function in patients on hemodialysis is unknown. METHODS:We studied the association between elevated pulmonary a...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000431334
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Interest in nephrology careers is declining, possibly due to perceptions of the field and/or training aspects. Understanding practices of medical schools successfully instilling nephrology interest could inform efforts to attract leading candidates to the specialty. METHODS:The American Society of Nephrolog...
journal_title:American journal of nephrology
pub_type: 杂志文章
doi:10.1159/000501058
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND/AIMS:Insulin is synthesised as a pro-hormone with an interconnecting C-peptide, cleaved during post-translational modification. This review discusses growing evidence which indicates that C-peptide is biologically active, benefiting microvascular complications associated with diabetes. METHODS:To explore th...
journal_title:American journal of nephrology
pub_type: 杂志文章,评审
doi:10.1159/000289864
更新日期:2010-01-01 00:00:00