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Outline
To construct symptom networks in patients with end⁃stage kidney disease before and after dialysis and to explore the dynamic interactions among different symptoms over time.
A total of 299 patients undergoing initial hemodialysis treatment at a tertiary grade A hospital in Sichuan province were selected as the study subjects from November 2024 to September 2025.Patients were surveyed using a self⁃designed general demographic questionnaire and an adapted version of the Dialysis Symptom Assessment Scale.A cross⁃lagged network model was employed to identify dynamic interactions among 18 symptoms over time.
The forward time⁃lagged correlation was sleep difficulty→itching(β=0.33).The backward time⁃lagged correlation was fatigue or lack of energy→sleep difficulty(β=-0.22).Sleep difficulty reported the greatest out⁃predictability(0.265),in⁃predictability(0.233),out⁃strength(1.498),and in⁃strength(1.591).
Sleep difficulty was identified as the core symptom of the dynamic network model of symptom before and after dialysis in patients with end⁃stage renal disease.Strategies to alleviate sleep difficulty should be incorporated into multimodal interventions for end⁃stage kidney disease.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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