Assessment of Fatigue in Patients with Chronic Kidney Disease:the Choice of Patient-reported Outcome Measures Scales

Background Fatigue is prevalent in patients with chronic kidney disease (CKD) and closely associated with reduced quality of life and increased mortality. Currently, Patient-reported Outcome Measures (PROMs) are commonly employed to assess fatigue. However, these measures exhibit variations in format. There is no consensus about how to choose an appropriate one to use in clinical practice. Objective: Systematically assess the advantages, disadvantages, and target populations of various scales to provide clinical practitioners with a reference for choosing appropriate assessment tools. Methods A systematic search of database like PubMed, Web of Science, CNKI, VIP, and Wanfang Data was conducted for literatures about fatigue assessment in patients with CKD, from January 2018 to April 2024. The data were independently screened and extracted by two researchers, and by comparing the assessment methods, advantages and disadvantages of each scale to inform the choice of fatigue assessment scales in different CKD populations. Results: The study reveals that CKD-related fatigue scales can be categorized into general fatigue scales and specific population fatigue scale. All these scales employ Likert scale for fatigue assessment. We found that health status survey instruments and the Dialysis Symptom Index Scale (DSI) were suitable for screening fatigue symptoms in CKD; the Piper Fatigue Scale-Revised (PFS-R) with multidimensional scale was the most commonly used in clinical practice and a promising scale for the assessment of fatigue in CKD because it could clearly differentiate between the degree and dimensions of fatigue. Conclusion: There are many fatigue scales to assess fatigue for patients with CKD. Clinical practitioners should consider the characteristics of the CKD study population comprehensively and choose the appropriate scale for fatigue assessment.