: Treatment Protocol for Lethargy in ESRD
Renal Palliative Care Initiative: Treatment Protocol for Lethargy in ESRD
This treatment protocol was created to address and manage symptoms of persistent
fatigue and post dialysis fatigue in patients with end stage renal disease.
Clinical Care Tools - Symptom Management
Renal Palliative Care Initiative
Baystate Medical Center
759 Chestnut Street S2669
Springfield, MA 01199
Michael Germain, M.D.
How the grantee used this instrument:
This protocol was made available at the clinics and renal unit nursing stations.
esrd, end stage renal disease, fatigue, lethargy, dialysis, kidney disease, symptom
To use this tool:
You may print and copy this tool for your own use from this site. Please credit
- Sklar, A, Riesenberg, LA, Silber, AK, Ahmed, W, et al. "Postdialysis
fatigue," American Journal of Kidney Disease, 1996; 28:732
- 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.
- 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;
- Brass, E, Adler, M, Sietsema, M, Hiatt,W, "Intravenous L-Carnitine
increases plasma carnitine, reduces fatigue, and may preserve exercise capacity
hemodialysis patients." American Journal of Kidney Disease, 2001;
- 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;
- Sobh, M, Hussein,
S, Tantawy, A, & Ghoneim, M, "Study of effect of
optimization of dialysis and protein intake on neuromuscular function I patients
hemodialysis treatment." American Journal of Nehprology. 1998; 18:399
- Kouidi, EJ. "Central
and peripheral adaptations to physical training in patients with end-stage
renal disease." Sports Medicine, 2001; 31:651.
- Johansen, K, Mulligan, K, & Schambelan,
M, "Anabolic effects of nandrolone decanoate in patients receiving dialysis."
JAMA 1999; 281:1275.
- 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.
To view this tool:
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Posted April 2004
Baystate Medical Center overview page
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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.