Interdialytic weight gain and fatigue in chronic kidney disease patients undergoing hemodialysis: A Correlational study
DOI:
https://doi.org/10.53713/nhsj.v5i2.482Keywords:
chronic kidney disease, fatigue, hemodialysis, interdialytic weight gainAbstract
Chronic Kidney Disease (CKD) has become a significant global health problem, characterized by the gradual and progressive damage to nephrons and decreased glomerular filtration rate which causes toxins in the body to accumulate and cause fatigue. One of the main problems experienced by hemodialysis patients is how to manage interdialytic weight gain (IDWG). Continuous excess extracellular fluid can cause adverse effects on the heart and respiratory function, which serves as the physiological basis for fatigue. This study aimed to analyze the relationship between IDWG and fatigue in CKD patients undergoing hemodialysis. This study used an analytical observational design with a cross-sectional approach. The sample used was 139 respondents using total sampling technique. Data collection of IDWG was conducted by a One Health digital weighing scale and Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale version 4 questionnaire. Data mean value IDWG 3.48% with a standard deviation of 1.72 and a median fatigue score of 26.0 with a low score of 12 and a high score of 46. Data were analyzed by using Spearman's rho correlation test with a significance level of 0.05. The results showed a weak negative relationship between IDWG and fatigue (p value <0.001 ; r = -0.385). It means that the higher the IDWG value, the lower the fatigue score, indicating that the fatigue level is more severe. This study highlights the importance of controlling IDWG to reduce fatigue levels in chronic kidney disease patients undergoing hemodialysis
References
Agustin, L., Mofidah, & Wardani, H. R. (2023). Nursing Care of Chronic Kidney Disease with Activity Intolerance Nursing Problems: A Case Study. Health and Technology Journal (HTechJ), 1(4), 400–405. https://doi.org/10.53713/htechj.v1i4.88
Ahmed, K., Dubey, M. K., Dubey, S., & Pandey, D. K. (2024). Chronic kidney disease: Causes, treatment, management, and future scope. Computational Intelligence for Genomics Data, 99-111. https://doi.org/10.1016/B978-0-443-30080-6.00010-9
Al Naamani, Z., Gormley, K., Noble, H., Santin, O., & Al Maqbali, M. (2021). Fatigue, anxiety, depression and sleep quality in patients undergoing haemodialysis. BMC nephrology, 22(1), 157. https://doi.org/10.1186/s12882-021-02349-3
Alfano, G., Perrone, R., Fontana, F., Ligabue, G., Giovanella, S., Ferrari, A., Gregorini, M., Cappelli, G., Magistroni, R., & Donati, G. (2022). Rethinking Chronic Kidney Disease in the Aging Population. Life, 12(11), 1724. https://doi.org/10.3390/life12111724
Arif, H. (2021). Complications of chronic kidney disease: electrolyte and acid-base disorders. In Approaches to Chronic Kidney Disease: A Guide for Primary Care Providers and Non-Nephrologists (pp. 211-233). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-83082-3_12
Bossola, M., Pepe, G., Antocicco, M., Severino, A., & Di Stasio, E. (2022). Interdialytic weight gain and educational/cognitive, counseling/behavioral and psychological/affective interventions in patients on chronic hemodialysis: a systematic review and meta-analysis. Journal of nephrology, 35(8), 1973-1983. https://doi.org/10.1007/s40620-022-01450-6
Bossola, M., Mariani, I., Strizzi, C. T., Piccinni, C. P., & Di Stasio, E. (2024). How to Limit Interdialytic Weight Gain in Patients on Maintenance Hemodialysis: State of the Art and Perspectives. Journal of Clinical Medicine, 14(6), 1846. https://doi.org/10.3390/jcm14061846
Canaud, B., & Cristol, J. (2021). Fluid Overload and Tissue Sodium Accumulation as Main Drivers of Protein Energy Malnutrition in Dialysis Patients. Nutrients, 14(21), 4489. https://doi.org/10.3390/nu14214489
Dewi, Y., Pujiastuti, T. T., & Maria, A. (2022). Hubungan Interdialytic Weight Gain (IDWG) dengan Hipertensi Intradialisis pada Pasien yang Menjalani Hemodialisis. Jurnal Keperawatan Klinis Dan Komunitas (Clinical and Community Nursing Journal), 6(3), 156. https://doi.org/10.22146/jkkk.75309
Engel, B., & Pugh, P. (2024). Nutrition in Kidney Disease. Renal Nursing: Care and Management of People with Kidney Disease, 288-325. https://doi.org/10.1002/9781394178797.ch12
Francis, A., Harhay, M. N., Ong, A. C., Tummalapalli, S. L., Ortiz, A., Fogo, A. B., Fliser, D., Fontana, M., Nangaku, M., Wanner, C., Malik, C., Hradsky, A., Adu, D., Bavanandan, S., Cusumano, A., Sola, L., Ulasi, I., & Jha, V. (2024). Chronic kidney disease and the global public health agenda: An international consensus. Nature Reviews Nephrology, 20(7), 473-485. https://doi.org/10.1038/s41581-024-00820-6
Gembillo, G., Calimeri, S., Tranchida, V., Silipigni, S., Vella, D., Ferrara, D., Spinella, C., Santoro, D., & Visconti, L. (2023). Lung Dysfunction and Chronic Kidney Disease: A Complex Network of Multiple Interactions. Journal of Personalized Medicine, 13(2), 286. https://doi.org/10.3390/jpm13020286
Gregg, L. P., Bossola, M., Ostrosky-Frid, M., & Hedayati, S. S. (2021). Fatigue in CKD. Clinical Journal of the American Society of Nephrology, 16(9), 1445–1455. https://doi.org/10.2215/CJN.19891220
Guo, Y., Zhang, M., Ye, T., Wang, Z., & Yao, Y. (2022). Application of Bioelectrical Impedance Analysis in Nutritional Management of Patients with Chronic Kidney Disease. Nutrients, 15(18), 3941. https://doi.org/10.3390/nu15183941
Jeong, R., Fidalgo, P., & Bagshaw, S. M. (2023). Chronic Kidney Disease in the Intensive Care Unit. In Management of Chronic Kidney Disease: A Clinician’s Guide (pp. 499-523). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-031-42045-0_34
Kirkman, D. L., Bohmke, N., Carbone, S., Garten, R. S., Rodriguez-Miguelez, P., Franco, R. L., Kidd, J. M., & Abbate, A. (2021). Exercise intolerance in kidney diseases: Physiological contributors and therapeutic strategies. American Journal of Physiology-Renal Physiology. https://doi.org/F-00437-2020
Kushwaha, R., Vardhan, P. S., & Kushwaha, P. P. (2023). Chronic Kidney Disease Interplay with Comorbidities and Carbohydrate Metabolism: A Review. Life, 14(1), 13. https://doi.org/10.3390/life14010013
La Porta, E., Lanino, L., Calatroni, M., Caramella, E., Avella, A., Quinn, C., ... & Esposito, P. (2021). Volume balance in chronic kidney disease: evaluation methodologies and innovation opportunities. Kidney and Blood Pressure Research, 46(4), 396-410. https://doi.org/10.1159/000515172
Lindberg, M. (2010). Excessive fluid Overload Among Haemodialysis Patient: Prevalence, Individual Characteristics And Self Regulation Fluid Intake. Acta Universitatis Upsaliensis Uppsala.
Lyons, O. D. (2024). Sleep disorders in chronic kidney disease. Nature Reviews Nephrology, 20(10), 690-700. https://doi.org/10.1038/s41581-024-00848-8
Maimani, Y. Al, Elias, F., Salmi, I. Al, Aboshakra, A., Alla, M. A., & Hannawi, S. (2021). Interdialytic Weight Gain in Hemodialysis Patients : Worse Hospital Admissions and Intradialytic Hypotension. 156–170. https://doi.org/10.4236/ojneph.2021.112013
Maisyaroh, A., Maslufin, M., Fibriyanti, D. O., Widianto, E. P., & Kurnianto, S. (2024). Anemia and Fatigue in Patients with Chronic Kidney Failure. Jurnal Kesehatan Manarang, 10(1), 51-58.
Nurdina, G., & Anggraeni, D. (2022). Interdialytic Body Weight Gain, Anxiety, Fatigue and Quality of Life in Hemodialysis Patients During the COVID-19 Pandemic. KnE Life Sciences, 2022(2018), 497–508. https://doi.org/10.18502/kls.v7i2.10348
Rothpletz-Puglia, P., Brown, T. L., Peters, E., Thomas-Hawkins, C., Kaplan, J., Myslinski, M. J., Mysliwiec, J., Parrott, J. S., & Byham-Gray, L. (2022). Functional Status and Engagement in Physical Activity Among Maintenance Dialysis Patients: A Mixed Methods Study. Kidney Medicine, 4(6), 100469. https://doi.org/10.1016/j.xkme.2022.100469
Safaroni, A., & Awaludin, S. (2023). Intervention Compliance of Diet and Fluids to Interdialytic Weight Gain in Patients with Chronic Kidney Disease Undergoing Hemodialysis: A Systematic Review. Babali Nursing Research, 4(2), 209–227. https://doi.org/10.37363/bnr.2023.42209
Sari, R. M., Isro’in, L., & Andayani, S. (2023, June). Impacts of Effective Use of IDWG Calculator on Physical Health of HD Patients. In 2nd International Conference of Health Innovation and Technology (ICHIT 2022) (pp. 123-131). Atlantis Press. https://doi.org/10.2991/978-94-6463-202-6_15
Sihombing, J. P., Hakim, L., Andayani, T. M., & Irijanto, F. (2016). Validation of Indonesian Version of FACIT Fatigue Scale Questionnaire in Chronic Kidney Disease (CKD) Patients with Routine Hemodialysis. Indonesian Journal of Clinical Pharmacy, 5(4), 231–237. https://doi.org/10.15416/ijcp.2016.5.4.231
Spahia, N., Rroji, M., Idrizi, A., Spasovski, G., & Barbullushi, M. (2024). Sodium and water dynamics in the progression of chronic kidney disease: mechanisms and clinical significance. International Urology and Nephrology, 56(6), 1953-1963. https://doi.org/10.1007/s11255-023-03903-8
Tennant, K. F. (2012). Assessment of Fatigue in Older Adults: The FACIT Fatigue Scale (Version 4). General Assessment Series from The Hartford Institute for Geriatric Nursing, New York, College of Nursing.
Thome, T., Kim, K., Dong, G., & Ryan, T. E. (2023). The role of mitochondrial and redox alterations in the skeletal myopathy associated with chronic kidney disease. Antioxidants & redox signaling, 38(4), 318-337. https://doi.org/10.1089/ars.2022.0143
Van der Borg, W. E., Verdonk, P., De Jong-Camerik, J., & Abma, T. A. (2021). How to relate to dialysis patients' fatigue - perspectives of dialysis nurses and renal health professionals: A qualitative study. International Journal of Nursing Studies, 117, 103884. https://doi.org/10.1016/j.ijnurstu.2021.103884
Wahyudi, Y. I., Fitriana, L. A., Ningrum, T. P., & Natasya, N. (2023). Hemodialysis Therapy Compliance in Chronic Kidney Disease Patients. Indonesian Journal of Community Development, 3(1), 24-36. https://doi.org/10.17509/ijcd.v3i1.56464
Wahyuni, L., Pratiwi, C. J., Haryanto, A., & Hariono, R. (2022). The Correlation of Long Term Hemodialysis and Inter Dyalisis Weight Gain (IDWG) in CKD Patients. Jurnal Ners dan Kebidanan (Journal of Ners and Midwifery), 9(2), 211-217. https://doi.org/10.26699/jnk.v9i2.ART.p211-217
wahyuni, lutfi, Rahmawati, I., & Achwandi, M. (2022). Relationship Motivation With Interdialityc Weight Gain (Idwg) Changes In Chronic Kidney Disease Patients. International Journal Of Nursing And Midwifery Science (IJNMS), 6(2), 155-162. https://doi.org/10.29082/IJNMS/2022/Vol6/Iss2/403
Wijayanti, L., Winoto, P. M. P., & Nursalam, N. (2021). How To Control Interdialytic Weight Gain (IDWG) Among Hemodialysis Patients? Nurse and Health: Jurnal Keperawatan, 10(2), 214–221. https://doi.org/10.36720/nhjk.v10i2.343
Xia, A., Meuleman, Y., Dekker, F. W., & Hoogeveen, E. K. (2025). Risk Factors and Potential Treatments for Fatigue in Patients with Advanced CKD: A Narrative Review. Kidney and Dialysis, 5(1), 8. https://doi.org/10.3390/kidneydial5010008
