The impact of fatigue on daily activity in people with chronic kidney disease

Aims and objectives. To examine the impact of fatigue on the daily activity levels of people with chronic kidney disease, compare whether being predialysis or receiving different renal replacement therapies had any effect on fatigue and activity and identify whether any items in the fatigue severity scale were more predictive of daily activity levels. Background. Chronic kidney disease is a complex and long-term disease where people commonly experience fatigue and reduced levels of fitness; both of which impact on an individual's ability to carry out routine activities of daily life. Design. A descriptive cross-sectional design. Methods. A convenience sample of 112 people completed the fatigue severity scale and Human Activity Profile. Participants differed in their renal history and were either predialysis or receiving renal replacement therapy. Results. Women or older participants were significantly more fatigued and less active than men or younger participants. A significant difference between mean fatigue and activity scores was found for type of renal replacement therapy, with participants receiving peritoneal dialysis being the most fatigued and the least active. Additionally, lower levels of albumin were significantly correlated with greater levels of fatigue and the ability to engage in fewer activities. Conclusion. People with chronic kidney disease regardless of whether they are predialysis or receiving either peritoneal or haemodialysis experience high levels of fatigue and are able to engage in fewer daily activities. The fatigue severity scale and the Human Activity Profile are useful indicators of fatigue and physical activities which can be used in routine assessment practices. Relevance to clinical practice. Renal nurses are ideally positioned to engage in early identification and regular monitoring of both fatigue and activity levels in people with chronic kidney disease. Individual care plans can be developed to incorporate supportive rehabilitative strategies which aim to reduce fatigue and maximise activity levels.