Insights into effective fatigue reducing interventions in kidney transplant candidates: a scoping review

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Fatigue is a prevalent and debilitating symptom among kidney transplant candidates (KTCs), significantly affecting their quality of life and overall well-being. Its complexity necessitates a comprehensive approach to manage fatigue in this population. To explore the effectiveness of nonpharmacological interventions in reducing fatigue in KTCs. Nonpharmacological interventions targeting fatigue in participants aged ≥18 years, who were either on the kidney transplantation waitlist or eligible candidates, were considered. A database search was conducted in PubMed, Embase, PsycINFO, CINAHL, and Web of Science. Results were reported in accordance with the guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols extension for Scoping Reviews Checklist. In total, 67 studies were included. Interventions were divided into manipulative and body-based practices, exercise, mind-body therapies, energy healing, and combined interventions. Thirty-eight studies (76%) demonstrated a significant effect on fatigue, with effect sizes ranging from 0.43 to 4.85. Reflexology, massage therapy, progressive muscle relaxation, and acupressure combined with massage therapy showed the strongest significant intervention effects on fatigue and had the strongest study quality. However, the overall study quality was weak, particularly concerning confounding control, blinding procedures, and withdrawals and dropouts. Manipulative and body-based interventions showed the strongest significant effects on fatigue with the highest study quality. These interventions underscore the multifactorial nature of fatigue by targeting both its physical and psychological dimensions. Future high-quality research is needed to determine the optimal strategy for managing fatigue in KTCs.