Effect of Acupressure on Fatigue in Hemodialysis Patients: A Single-Blinded Randomized Controlled Trial

Made Suandika, Shih Ying Chen, Ji Tseng Fang, Sien Hung Yang, Yun Fang Tsai, Li Chueh Weng, Pei Kwei Tsay, Woung Ru Tang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

1 Scopus citations


Objectives: The objective of this study was to investigate the effect of acupressure on fatigue severity, sleep quality, and psychological status in patients with end-stage renal disease (ESRD) receiving hemodialysis (HD) treatment. Design: A single-blinded parallel-group randomized controlled trial. Settings/Location: A medical center in central Java, Indonesia. Subjects: One hundred and six patients who had been receiving HD for at least 3 months were enrolled in this study and randomly assigned to two groups. Interventions: The experimental group received acupressure at K1, ST36, and SP6 acupoints. In contrast, the control group received sham acupressure at 1 cun from these three acupoints. Subjects received acupressure thrice per week for 4 weeks, and pressure on each acupoint was applied for 3 min bilaterally. Outcome measures: The primary outcome was fatigue severity, while sleep quality and psychological status (depression/anxiety) were evaluated as secondary outcomes. Outcomes were assessed using the Brief Fatigue Inventory, Pittsburgh Sleep Quality Index, and Hospital Anxiety and Depression Scale. Results: Acupressure induced a significant medium to large effect on improvement in fatigue ( b  = -1.71, confidence interval [95% CI]: -1.90 to -1.51, ΔR 2  = 0.744), sleep quality ( b  = -5.81, 95% CI: -6.80 to -4.81, ΔR 2  = 0.525), and anxiety ( Estimate  = -3.213, 95% CI: -4.238 to -2.188, pseudo R 2  = 0.292)/depression ( Estimate  = -3.378, 95% CI: -4.432 to -2.325, pseudo R 2  = 0.268) in experimental group patients compared to controls. No adverse events of acupressure were reported during the study process. Conclusions: Acupressure significantly and independently improved fatigue, depression/anxiety, and sleep quality in ESRD patients receiving HD. Clinical Trial Registration: NCT05571007.

Original languageEnglish
Pages (from-to)111-118
Number of pages8
JournalJournal of Integrative and Complementary Medicine
Issue number2
StatePublished - 01 02 2023

Bibliographical note

Publisher Copyright:
© Copyright 2023, Mary Ann Liebert, Inc., publishers 2023.


  • acupressure
  • anxiety/depression
  • end-stage renal disease
  • fatigue
  • hemodialysis
  • sleep
  • Fatigue/etiology
  • Acupressure
  • Humans
  • Sleep Quality
  • Renal Dialysis/adverse effects
  • Kidney Failure, Chronic/therapy


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