Promoting Excellence : Treatment Protocol for Lethargy in ESRD

Name:
Renal Palliative Care Initiative: Treatment Protocol for Lethargy in ESRD

Description:
This treatment protocol was created to address and manage symptoms of persistent fatigue and post dialysis fatigue in patients with end stage renal disease.

Category:
Clinical Care Tools - Symptom Management

Source:
Renal Palliative Care Initiative
Baystate Medical Center
759 Chestnut Street S2669
Springfield, MA 01199

Contact:
Michael Germain, M.D.
[email protected]

How the grantee used this instrument:
This protocol was made available at the clinics and renal unit nursing stations.

Keywords:
esrd, end stage renal disease, fatigue, lethargy, dialysis, kidney disease, symptom assessment

To use this tool:
You may print and copy this tool for your own use from this site. Please credit source.

References:

1. Sklar, A, Riesenberg, LA, Silber, AK, Ahmed, W, et al. "Postdialysis fatigue," American Journal of Kidney Disease, 1996; 28:732
2. Sklar, A, Newman, N, Scott, R, Semenyuk, L, et al. "Identification of factors responsible for postdialysis fatigue." American Journal of Kidney Disease, 1999: 34:464.
3. Robertson, H, Kaky, N, Gurthrie, M, Cardenas, D, et al. "Recombinant erythropoietin improves exercise capacity in anemic hemodialysis patients." American Journal of Kidney Disease, 1990; 4:325.
4. Brass, E, Adler, M, Sietsema, M, Hiatt,W, "Intravenous L-Carnitine increases plasma carnitine, reduces fatigue, and may preserve exercise capacity in hemodialysis patients." American Journal of Kidney Disease, 2001; 37:1018
5. Wuerth, D, Finkelstein, S, Ciarcia, M, Peterson, R, et al. "Identification and treatment of depression in a cohort of patients maintained on chronic peritoneal dialysis." American Journal of Kidney Disease, 2001; 37:1011.
6. Sobh, M, Hussein, S, Tantawy, A, & Ghoneim, M, "Study of effect of optimization of dialysis and protein intake on neuromuscular function I patients under maintenance hemodialysis treatment." American Journal of Nehprology. 1998; 18:399
7. Kouidi, EJ. "Central and peripheral adaptations to physical training in patients with end-stage renal disease." Sports Medicine, 2001; 31:651.
8. Johansen, K, Mulligan, K, & Schambelan, M, "Anabolic effects of nandrolone decanoate in patients receiving dialysis." JAMA 1999; 281:1275.
9. Breitbart, W, Rosenfeld, B, Kaim, M, & Funesti-Esch, J, "A randomized, double-blind, placebo-controlled trial of psychostimulants for the treatment of fatigue in ambulatory patients with human immunodeficiency virus disease." Archives of Internal Medicine, 2001: 411.

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Posted April 2004

Baystate Medical Center overview page

# BMC14, type:symptom_management

Promoting Excellence in End-of-Life Care was a national program of the Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying people and their families. Visit PromotingExcellence.org for more resources.