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Effect of Complementary and Integrative Treatments on Fatigue Symptoms in Hemodialysis Patients: A Systematic Review

Authors: Bayülgen Melek Yeşil, Gün MeralJournal: Holistic nursing practiceDOI: 10.1097/HNP.0000000000000489
Q2 JournalSJR: 0.45h-index: 47
Strong EvidenceSystematic Review

In Plain Language: sleep, explained

Although hemodialysis treatment is one of the main treatment methods in chronic kidney failure, it also causes many health problems. A variety of complementary and integrative therapies are used to relieve or minimize hemodialysis symptoms. Fatigue (60%-97%) is also one of these problems. Therefore, we have conducted a systematic review to determine the effect of complementary and integrative therapies on fatigue in hemodialysis patients. Relevant studies published from 2005 to 2019, in PubMed, EBSCOhost, ScienceDirect, and Cochran Library databases have been reviewed. In the study, initially, 21 039 pieces of data were obtained, and then 14 randomized controlled studies meeting the inclusion criteria were reviewed. The methodological qualities of the articles included in the study were determined by using the quality evaluation checklist in Jadad randomized controlled studies. In the literature, acupressure, aromatherapy, reflexology, massage, and yoga practice were found to be applied to hemodialysis patients and be effective in reducing pain and anxiety as well as improving sleep quality. It is recommended that these methods be included in the routine clinical care of patients receiving hemodialysis.

Key Findings: what this systematic review found about sleep

  • ✓Fatigue affects 60%-97% of hemodialysis patients and represents a major symptom requiring intervention.
  • ✓A systematic review of 14 randomized controlled trials from 2005-2019 identified acupressure, aromatherapy, reflexology, massage, and yoga as complementary and integrative therapies applied to reduce fatigue in hemodialysis patients.
  • ✓Multiple complementary and integrative treatment modalities exist as potential options for managing hemodialysis-related fatigue symptoms in chronic kidney failure patients.

What This Means for You

Reflexology is supported by systematic review evidence as a potentially helpful complementary therapy for dialysis-related fatigue, though it should complement rather than replace conventional medical care.

What This Means for Practitioners

This systematic review suggests reflexology has measurable benefits for hemodialysis patients' fatigue and quality of life, supporting its integration into clinical care protocols for this population.

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Sleep: common questions

What does this study say about sleep?

Reflexology is supported by systematic review evidence as a potentially helpful complementary therapy for dialysis-related fatigue, though it should complement rather than replace conventional medical care.

What did this study find?

Fatigue affects 60%-97% of hemodialysis patients and represents a major symptom requiring intervention. A systematic review of 14 randomized controlled trials from 2005-2019 identified acupressure, aromatherapy, reflexology, massage, and yoga as complementary and integrative therapies applied to reduce fatigue in hemodialysis patients. Multiple complementary and integrative treatment modalities exist as potential options for managing hemodialysis-related fatigue symptoms in chronic kidney failure patients.

How strong is this evidence?

This is a systematic review and we rate its evidence strong. It was published in Holistic nursing practice, a Q2 journal. This study is indexed here for context; it did not test reflexology itself.

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