International Urology and Nephrology

, Volume 50, Issue 7, pp 1329–1339 | Cite as

Relationship between fatigue symptoms and subjective and objective indicators in hemodialysis patients

  • Manhua Zuo
  • Jun Tang
  • Miaomiao Xiang
  • Qing Long
  • Jianping Dai
  • Xiuying Hu
Nephrology - Original Paper



The purpose of the study was to investigate the major factors affecting fatigue symptoms and to examine the relationships between fatigue symptoms and subjective and objective indicators in patients on hemodialysis (HD).


Patients on HD who met the inclusion criteria were chosen from two grade A tertiary general hospitals by convenience sampling and cross-sectional survey methods.


A total of 511 patients were included in the study. The morbidity rate of fatigue in patients on HD was 61.6%, and the median fatigue level was 3.91. Fatigue and subjective indicators showed a mild-moderate relationship (0.3 < all |r| < 0.6, all P < 0.001), whereas a weak correlation was found between fatigue and objective indicators (all |r| < 0.2, all P < 0.05). Multivariate analysis showed that subjective indicators, including employment, exercise time, appetite, the vitality of 36-item Short Form Health Survey, perceived social support, intrafamilial support, cramping, headache, chest tightness, and whole-body pain, as well objective indicator, such as serum intact parathyroid hormone levels, were the influence factors of fatigue in patients on HD.


The prevalence of fatigue symptoms was high and the level of fatigue was moderate in patients on HD. Subjective and objective indicators can both affect fatigue symptoms in patients on HD.


Hemodialysis Fatigue Subjective indicator Objective indicator 



We thank hemodialysis staff of the two dialysis centers who granted us support of the overall study process. We are also grateful to Manhua Zuo’s doctoral advisor, Xiuying Hu, Professor MD, who supervised the study design. We also thank Jun Tang, Deputy Director of the Nephrology Department, who rigorously monitored extraction of the indicators and communication with patients throughout the process, as well as the research staff, including Jianping Dai, Qing Long, and Miaomiao Xiang, who assisted in data collection and management. This research received funding from the Young and Middle-Aged Talents Project in Hubei Provincial Department of Education (Q20161905).

Compliance with ethical standards

Conflict of interest

All authors declare no conflicts of interest.

Supplementary material

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Supplementary material 1 (DOCX 17 KB)
11255_2018_1871_MOESM2_ESM.docx (16 kb)
Supplementary material 2 (DOCX 16 KB)


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Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  1. 1.West China Nursing School/West China HospitalSichuan UniversityChengduChina
  2. 2.School of MedicineHubei Institute for NationalitiesEnshiChina
  3. 3.Department of NephrologyThe Central Hospital of Enshi Autonomous PrefectureEnshiChina

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