Dialysis Unit Differences in Post-Dialysis Fatigue Prevalence and Characteristics and Time to Recovery After Dialysis

Introduction: Patients with end-stage renal disease (ESRD) undergoing chronic hemodialysis (HD) frequently report the sensation of prostration, tiredness, weakness, exhaustion, weariness, or fatigue after the hemodialysis treatment. This condition is defined as post-dialysis fatigue and significantly impairs patients' ability to perform routine daily activities. The present study aims to investigate whether territorial or environmental factors such as differences in geographic areas are associated with the prevalence and characteristics of post-dialysis fatigue and time to recovery after dialysis among chronic HD patients. Methods: A total of 465 patients from six Italian HD units, located in both northern and central Italy, were enrolled between January and December 2024. Exclusion criteria included a dialysis duration of less than 1 year and a diagnosis of dementia, acute infectious disease, or active cancer. For each participant, demographic, clinical, and laboratory data were collected. Findings: The results showed that 61.5% of the patients reported suffering from post-dialysis fatigue. The prevalence and characteristics of post-dialysis fatigue, as well as the length of time to recovery after dialysis, varied significantly among the six HD units. Multivariate analyses revealed that the hemodialysis unit itself was the main variable significantly and independently associated with both post-dialysis fatigue and time to recovery after dialysis. Conclusions: Our findings suggest that environmental factors such as differences in geographic areas are associated with the prevalence and characteristics of post-dialysis fatigue and time to recovery after dialysis among chronic HD patients.