A prospective study of fatigue trajectories among in-centre haemodialysis patients, 2020, Picariello, Moss-Morris et al

Open access, https://bpspsychub.onlinelibrary.wiley.com/doi/full/10.1111/bjhp.12395

 

For example, once fatigue develops as a consequence of underlying disease processes, interpretations of fatigue as uncontrollable and lasting, and unhelpful thinking styles in response to fatigue, such as catastrophizing, symptom focusing, or perceiving fatigue as a sign of bodily damage (damage beliefs), may lead to increased anxiety and low mood and subsequently unhelpful behavioural responses, such as excessive rest in an attempt to control fatigue and reduce the damage perceived it is doing to their body. Excessive rest may in turn lead to deconditioning, poor sleep and physiological arousal related to anxious mood, and lead to the perpetuation of fatigue

Blissfully unconstrained by evidence, as always.

 

This is not how it works. It's just marketing for CBT.

 

Kidney disease, serious enough to require Haemodialysis (HD) is dreadful. The waste products you normally excrete build up until your next session, typically 3 times a week.
Your fluid intake and diet are hugely restricted.
These patients have every right to feel dreadful.

What is it with these Psychs and how are they continually accessing the funds for this this drivel!

 

I worked as a nurse with chronic dialysis patients for twenty years.

A large chunk of the dialysis population is over 65, which can account for some increase in fatigue.

My observations always concluded that the more uremic (abnormal levels of nitrogen waste products the blood---this corresponds to how much residual kidney function a dialysis patient has and also how strictly they follow their limiting of protein in their diets) a patient is, the more fatigue they have.

The higher level of nitrogen wastes in the blood make them feel sicker, thus more fatigued. Those levels have a direct effect on the brain.

Also, when potassium levels are high (almost every patient has higher than normal potassium levels just before dialysis) muscles feel and are weak. Thus, fatigue.

And almost all have some degree of depression. They know that their livespans are greatly reduced once they get to the end stage renal failure.

Edited to add: Kidney function continues to deteriorate with time on dialysis. So, fatigue will increase for that reason, too.

 

Copy-paste research with copy-paste conclusions written from the start. Zero value, this informs nothing.

What this really shows is how completely arbitrary their stuff is, that whatever you put in, you always get the exact same thing out: the thing they believe. It also shows that patient predictions about their own course are generally reliable enough to serve as prognosis, probably not on a per-case basis but significantly more accurate than anything these fools have been trying for decades anyway. In a way, this is a massive ongoing self-own. But evidence does not matter in evidence-based medicine so whatever.

 

this trash is published for profit the publishing houses make in excess of two and a half billion every year the ridiculous prices they charge to read texts that they get for free guarantees that considerable amounts of copy pasted drivel will be published . i wish the law makers would get of their collective buts and bring an end to these hugely fraudulent practices .

 

Agreed, except that it's not fraud til after the lawmakers do the right thing. Until then it's merely creepily unethical. And stands as one of the pillars that will bring us into a dark age where everything anyone says is science. Because they said so. And they're an expert.

 

If doctors read these things at all the constant repetition will make this story sound true. We notice all the "mays" and "mights" but they are easy to miss. They are also an admission that there is no evidence for their theory. Obviously because they never test it just twist everything to make it sound true.

 

I used to maintain dialysis machines, including in people's homes.

Those patients are tired and unwell at least 50-60% of the time, are never 100% well, and have a bunch of serious complications from the kidney disease.

I wouldn't wish it on anybody.