Evidence map›Paper›PMID 30955947›Full record

SynthesisAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2019

Patient Perspectives on the Meaning and Impact of Fatigue in Hemodialysis: A Systematic Review and Thematic Analysis of Qualitative Studies.

Jack Jacobson, Angela Ju, Amanda Baumgart, Mark Unruh, Donal O'Donoghue, Gregorio Obrador, Jonathan C Craig, Juan M Dapueto, Mary Amanda Dew, Michael Germain and 6 more

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 4 pooled it
9.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 4 syntheses or guidelines pooled it, 109 citations in OpenAlex.

  1. Pooled it
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  3. Effect of online hemodiafiltration on quality of life, fatigue and recovery time: a systematic review and meta-analysis.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2025
    Pooled it
  4. Exercise training for adults undergoing maintenance dialysis.The Cochrane database of systematic reviews · 2022
    Pooled it
  5. Occupational Priorities of People on Hemodialysis Who Participated in Energy Management Education.Canadian journal of occupational therapy. Revue canadienne d'ergotherapie · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 13 institutions in 6 countries.

Jack JacobsonSydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia.
Angela JuSydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia.
Amanda BaumgartSydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia.
Mark UnruhDepartment of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM.
Donal O'DonoghueDepartment of Renal Medicine, Salford Royal Hospital, Salford, United Kingdom.
Gregorio ObradorUniversidad Panamericana School of Medicine, Mexico City, Mexico.
Jonathan C CraigCollege of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
Juan M DapuetoDepartamento de Psicología Médica. Facultad de Medicina. Universidad de la República. Montevideo, Uruguay.
Mary Amanda DewDepartment of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Michael GermainRenal and Transplant Associates of New England, Division of Nephrology, Baystate Medical Center, Tufts University School of Medicine, Boston, MA.
Richard FluckDepartment of Renal Medicine, Royal Derby Hospital, Derby, United Kingdom.
Sara N DavisonDivision of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Alberta.
Sarbjit Vanita JassalDivision of Nephrology, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Karine ManeraSydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia.
Alice C SmithDepartment of Health Sciences, University of Leicester, Leicester, United Kingdom.
Allison TongSydney School of Public Health, The University of Sydney, Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia. Electronic address: allison.tong@sydney.edu.au.
The University of Sydney · AUBaystate Medical Center · USChildren's Hospital at Westmead · AUFlinders University · AURoyal Derby Hospital · GBSalford Royal Hospital · GBUniversidad de la República de Uruguay · UYUniversidad Panamericana · MXUniversity Health Network · CAUniversity of Alberta · CAUniversity of Leicester · GBUniversity of New Mexico · USUniversity of Pittsburgh · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

RATIONALE &

objectiveFatigue is a highly prevalent and debilitating symptom in patients on hemodialysis therapy due to the uremic milieu, the hemodialysis treatment itself, and other comorbid conditions. However, fatigue remains underrecognized and the consequences are underappreciated because it may not be visible in clinical settings. This study aims to describe the experience that patients undergoing maintenance hemodialysis have with fatigue. STUDY

designSystematic review and thematic synthesis of qualitative studies. SETTING & STUDY POPULATIONS: Patients undergoing hemodialysis. SEARCH STRATEGY & SOURCES: MEDLINE, Embase, PsycINFO, CINAHL, reference lists, and PhD dissertations were searched from inception to October 2018. DATA EXTRACTION: All text from the results/conclusion of the primary studies. ANALYTICAL APPROACH: Thematic synthesis.

results65 studies involving 1,713 participants undergoing hemodialysis were included. We identified 4 themes related to fatigue: debilitating and exhausting burden of dialysis (bodily depletion, trapped in a vicious cycle of postdialysis exhaustion, vigilance and worry inhibiting rest, tiresome and agonizing regimen, and without remedy and relief), restricted life participation (deprived of time, managing energy reserves, frustrating need to rest, and joys foregone), diminishing capacities to fulfil relationship roles (losing ability to work and provide for family, failing as a parent, lacking stamina for sexual intimacy, and relying on others), and vulnerable to misunderstanding (being criticized for the need to rest and failing to meet expectations). LIMITATIONS: Non-English articles were excluded and most studies were conducted in high-income countries.

conclusionsFor patients undergoing hemodialysis who experience fatigue, fatigue is a profound and relentless exhaustion that pervades the entire body and encompasses weakness. The fatigue drains vitality in patients and constrains their ability to do usual activities and fulfill their roles and meet personal aspirations. Explicit recognition of the impact of fatigue and establishing additional effective interventions to improve fatigue are needed.

Indexed as

Attitude to HealthFatigueHumansQualitative ResearchRenal Dialysischronic diseasedialysisend-stage kidney disease (ESKD)exhaustionFatiguehemodialysis (HD)lack of energyoutcomespatient-centered carepatient-reported outcome measure (PROM)postdialysis fatiguequalitative researchquality of life (QoL)systematic reviewtirednessweakness

Identifiers

PMID30955947
OpenAlexW2932834721

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.