The goal of this clinical trial is to learn if laser acupuncture (low-level laser therapy) works to treat fatigue and improve quality of life in adults with end-stage renal disease (ESRD) undergoing hemodialysis. It will also learn about how laser acupuncture affects blood circulation and autonomic nervous system balance. The main questions it aims to answer are: 1. Does laser acupuncture reduce the severity of fatigue and its interference with daily life? 2. Can laser acupuncture improve related symptoms such as insomnia, poor appetite, and skin itching? 3. How does laser acupuncture affect objective markers like microcirculation and heart rate variability? Researchers will compare laser acupuncture to a sham treatment (a look-alike procedure using a device that does not emit a laser) to see if laser acupuncture works to treat fatigue. Participants will: 1. Receive laser acupuncture or a sham treatment during their regular hemodialysis sessions 3 times a week for 4 weeks. 2. Have their fatigue and life quality assessed through questionnaires on the first day, at 4 weeks, and at 8 weeks. 3. Undergo non-invasive tests to measure microcirculation, heart rate variability, and pulse waves, and have photos of their tongue taken for Chinese medicine assessment.
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VAS for fatigue
Timeframe: Baseline (Day 0), Week 4 (end of intervention), and Week 8 (follow-up).
Brief Fatigue Inventory (BFI)
Timeframe: Baseline (Day 0), Week 4 (end of intervention), and Week 8 (follow-up).