Intradialytic Symptoms and Recovery Time in Patients on Thrice-Weekly In-Center Hemodialysis: A Cross-sectional Online Survey

Abstract

RATIONALE & OBJECTIVE: Patients experience various symptoms during hemodialysis. We aimed to assess the frequency and severity of symptoms during hemodialysis and whether intradialytic symptoms are associated with recovery time postdialysis. STUDY DESIGN: An online questionnaire was sent to 10,000 patients in a National Kidney Foundation database. SETTING & PARTICIPANTS: Adult patients receiving in-center hemodialysis 3 times weekly for 3 or more months. EXPOSURE: Online questionnaire. ANALYTIC APPROACH: Tabulation of frequency and severity of events and recovery time as percent of respondents, construction of a total symptom score, followed by rank correlation analysis of symptom characteristics with total recovery time. OUTCOMES: Patient-reported intradialytic symptoms and recovery time postdialysis. RESULTS: < 0.0001). 40% of patients had time to recovery times of 4 hours or longer. 1 in 3 patients reported having stopped dialysis early for intradialytic symptoms and 6% reported skipping dialysis at least once because of intradialytic symptoms. LIMITATIONS: Recall-based self-reported data with a relatively low response rate. CONCLUSIONS: A majority of patients receiving in-center hemodialysis experience symptoms such as feeling washed out, fatigue, and cramping; these may be severe and are correlated with longer recovery time following hemodialysis, as well as shortened and skipped hemodialysis sessions.