| [ Summary ] |
Many factors are considered to be causes of fatigue in dialysis patients. There has been controversy as to whether the removal of accumulated uremic toxins through maintenance dialysis contributes to improvements in levels of fatigue. Fatigue may be related to the differential between intracellular and extracellular osmotic pressure induced by dialysis, anemia and metabolic disorders related to carnitine levels associated with uremia.
Dialysates essentially consist of buffering agents such as acetate, lactate, and bicarbonate, electrolytes, and glucose. In addition, dialysates must be endotoxin free. Acetic acid intolerance and lactate accumulation may lead to development of fatigue. Hypercalcemia, hypermagnesemia, and the glucose concentration disorders may be potent causative factors for fatigue. Cytokines induced by endotoxins have been reported to lead to fatigue in dialysis patients. |