{"doi":"10.1016/j.xkme.2020.02.001","title":"Intradialytic Symptoms and Recovery Time: Thinking ‘Outside the Box’ to Improve Patients’ Dialysis Experience","abstract":"Related Article, p. 125 Related Article, p. 125 In this issue of Kidney Medicine, Alvarez et al,1Alvarez L. Brown D. Hu D. Chertow G.M. Vasalotti J.A. Prichard S. Intradialytic symptoms and recovery time in patients on thrice weekly in-center hemodialysis: a cross-sectional online survey.Kidney Med. 2020; 2: 125-130Abstract Full Text Full Text PDF Scopus (8) Google Scholar using responses to a National Kidney Foundation scientific survey, present an informative and timely study detailing self-reported symptoms during in-center hemodialysis and associations between symptoms experienced during dialysis with recovery time after dialysis treatments. Dialysis recovery time is an important concept that encapsulates challenges experienced by dialysis patients contributing to impaired health-related quality of life.2Awuah K.T. Afolalu B.A. Hussein U.T. Raducu R.R. Bekui A.M. Finkelstein F.O. Time to recovery after a hemodialysis session: impact of selected variables.Clin Kidney J. 2013; 6: 595-598Crossref PubMed Scopus (17) Google Scholar Recovery time is measured by asking the reliable, valid, and responsive question, “How long does it take you to recover from a dialysis session?”3Lindsay R.M. Heidenheim P.A. Nesrallah G. Garg A.X. Suri R. Minutes to recovery after a hemodialysis session: a simple health-related quality of life question that is reliable, valid, and sensitive to change.Clin J Am Soc Nephrol. 2006; 1: 952-959Crossref PubMed Scopus (150) Google Scholar Using an online symptom questionnaire modified from the Kidney Disease Quality of Life Symptoms and Problems With Kidney Disease scale,4Hays R.D. Kallich J.D. Mapes D.L. Coons S.J. Carter W.B. Development of the Kidney Disease Quality of Life (KDQOL) instrument.Qual Life Res. 1994; 3: 329-338Crossref PubMed Scopus (818) Google Scholar Alvarez et al queried patients’ experiences of a range of symptoms, including fatigue, low blood pressure, cramps, headache, faintness or dizziness, itchy skin, nausea or upset stomach, vomiting, shortness of breath, irregular heart rate, chest pain, and difficulty concentrating during dialysis in the previous week. A total symptom score for each patient was derived from the product of the number and average severity of symptoms. In this cross-sectional study, Alvarez et al asked about average dialysis recovery time during the previous week: “Over the last week, how long did it take you on average to recover from your dialysis sessions and resume your normal, usual activities?” They also asked about dialysis treatment nonadherence, including skipping and shortening of treatments. Of 10,000 patients sent the online questionnaire, only 464 (4.6%) responded, raising some questions about the generalizability of the results. Nevertheless, most (87%) patients reported burdensome symptoms during dialysis, including fatigue (67%), cramps (44%), and low blood pressure (42%). Median reported dialysis recovery time was 3 hours, and this moderately correlated with the incidence and severity of intradialytic symptoms (τ = 0.28: 90% CI, 0.26-0.38; P < 0.0001). A third of the patients credited intradialytic symptoms to shortening their dialysis treatments, and a minority (6%) of patients attributed missed dialysis sessions to their intradialytic symptoms. This important study builds on structured assessments of dialysis-related symptom burden and its implications for the experience and delivery of the dialysis procedure. It also contributes direct confirmatory testimony from patients that their ability to fulfill their dialysis prescription is influenced by their symptoms during treatment. Although this may not be surprising, it emphasizes the importance of assessing and addressing symptoms systematically, rigorously, and proactively as a central component of dialysis care. Patient-centered care in dialysis requires a multifaceted approach to better understand influential patient factors5Yoowannakul S. Tangvoraphonkchai K. Davenport A. Patient-reported int","journal":"Kidney Medicine","year":2020,"id":128989,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9578,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":340082,"name":"Kerri L. Cavanaugh","orcid":"0000-0002-4031-1714","position":1,"is_corresponding":false},{"id":340079,"name":"Ebele M. Umeukeje","orcid":"0000-0003-2070-6433","position":0,"is_corresponding":true}],"reference_count":18,"raw_metadata":null,"created_at":"2026-07-18T23:15:42.522809Z","pmid":"32734955","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}