Digital health management of fatigue in hemodialysis patients: a scoping review (Preprint)

BACKGROUND Hemodialysis patients commonly experience dialysis-related fatigue, a distressing symptom that substantially impairs daily functioning, treatment adherence, and overall quality of life. In recent years, the rapid development of digital health technologies has enhanced continuity of care for hemodialysis patients and offered novel approaches for the management of dialysis-related fatigue. However, systematic evidence regarding the application characteristics and effectiveness of digital health technologies in this context remains limited. OBJECTIVE This study aimed to systematically review the types and effectiveness of digital health technologies used to manage dialysis-related fatigue in hemodialysis patients, to analyze their advantages and limitations, and to provide evidence to inform future clinical practice. METHODS A comprehensive and systematic literature search was independently conducted by two reviewers according to predefined inclusion and exclusion criteria. The following databases were searched from inception to November 18, 2025: China National Knowledge Infrastructure, Wanfang Data, VIP Database, Chinese Biomedical Literature Database, PubMed, Embase, Web of Science, CINAHL, and the Cochrane Library. After study selection, relevant data were extracted, including authorship, country, year of publication, study design, sample size, type of digital health intervention, application mode, frequency or duration of use, delivery format, and outcome measures. RESULTS A total of 1,450 records were initially identified, of which 12 studies met the inclusion criteria. The included studies were conducted across six countries: the United States, China, the Netherlands, South Korea, Iran, and Egypt. Study designs included four randomized controlled trials (33%), three observational studies (25%), two quasi-experimental studies (17%), one mixed-methods study (8.3%), one pilot study (8.3%), and one pre–post study (8.3%). Most studies (11/12, 92%) reported beneficial effects of digital health interventions on fatigue management in patients undergoing maintenance hemodialysis. CONCLUSIONS Digital health technologies demonstrate promising effectiveness and feasibility in managing dialysis-related fatigue among maintenance hemodialysis patients. These interventions may alleviate fatigue through functional exercise programs, cognitive and psychological support, online supervision, and real-time feedback. Nevertheless, considerable heterogeneity exists across studies in terms of intervention content, delivery formats, outcome measures, and reported effects. Further standardization and high-quality research are warranted to optimize the application of digital health technologies for fatigue management in this population. CLINICALTRIAL https://doi.org/10.17605/OSF.IO/7MQUN.