Hadadian 2016.

Study characteristics
Methods	Study design Parallel RCT Study dates Duration of follow‐up: 5 weeks Time frame: February to July 2009
Participants	Study characteristics Setting: multicentre (2 dialysis centres in major hospitals in Ahvaz‐Iran Kermanshah (Imam Khomeini and Golestan hospitals), Iran) Country: Iran Inclusion criteria: ≥ 15 years; diagnosed with ESKD; had been treated with HD for at least 3 months and complained of fatigue Exclusion criteria: lower extremity amputation; pacemaker; complications requiring immediate medical intervention; under psychological medications; hospital admission for any other reason; needed a blood transfusion; surgery; having infection and bleeding Baseline characteristics Number (analysed/randomised): intervention group (28/30); control group (28/30) Mean age ± SD (years): intervention group (48.15 ± 15.5); control group (56 ± 14.6) Sex (M/F): intervention group (20/8); control group (18/10) Dialysis type: HD Mean dialysis vintage ± SD (years): overall (2.75 ± 3.27); intervention group (2.13, SD not reported); control group (2.62, SD not reported) Comorbidities CVD: not reported Diabetes: not reported Hypertension: not reported Depression (clinician diagnosis): not reported
Interventions	Intervention classification Non‐pharmacological intervention Indication: study targeting fatigue Intervention group TEAS for 5 weeks Control group Sham TEAS for 5 weeks Co‐interventions Not reported
Outcomes	Outcomes reported Fatigue outcome measures used: validation data available Fatigue Chinese version of the BFI (Appendix 3): assessed at baseline and end of treatment Fatigue in the last week Fatigue right now Usual level of fatigue during past 24 hours Worst level of fatigue during past 24 hours How during the past 24 hours, fatigue has interfered with general activity, mood, walking ability, normal work, relations with other people, enjoyment of life General fatigue
Notes	Additional information Funding: Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Conflicts of interest/disclosures: not reported Trial registration identification number: not reported (this trial was non‐registry in IRCT because the project was conducted in 2009, and in that time, the registration was optional for the universities) A priori published protocol: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "Fifty six patients who had undergone haemodialysis and meeting the inclusion criteria, were divided into two groups by simple random sampling." Comment: Sequence generation methods were not reported in sufficient detail to permit judgement
Allocation concealment (selection bias)	Unclear risk	Method of allocation concealment was not reported in sufficient detail to permit judgement
Blinding of participants and personnel (performance bias) All outcomes	High risk	Quote: "This study was done as a single‐blind clinical trial. [...] TEAS group treated by acupuncture in real points, while, in the TEAS‐Sham patients, based on the acupuncture expert opinion, the procedure was implemented for them in the false points, so that the patients were not aware of their grouping and blinded about it." Comment: A single‐blind study is considered as high risk of bias
Blinding of outcome assessment (detection bias) All outcomes	High risk	Quote: "The questionnaires were filled up by the researcher before and after 10th session of intervention." Comment: The outcomes were assessed with an appropriate measure, without differences between groups. However, subjective measures were used, it was not stated whether outcomes were assessed without knowledge of treatment allocation, and knowledge of treatment assignment may have influenced reporting. Participant/investigators beliefs about the superiority/inferiority of either intervention could have influenced their assessment of the outcome, but there was no evidence that this was likely. It was not stated if the interviewer was blinded to the treatment allocation
Incomplete outcome data (attrition bias) All outcomes	High risk	Quote: "In this study 95 patients were screened, 72 patients met the inclusion criteria and 60 patients agreed and consented to the study. Four patients were excluded over the intervention: 2 in the TEAS group and 2 in the sham group. Finally, 56 cases including 28 cases in the TEAS group and 28 cases in the Sham group completed the research." Comment: 28/30 participants in the intervention group and 28/30 participants in the control group completed the study (> 5% lost to follow‐up, without differences between groups). Reasons for discontinuations were not reported
Selective reporting (reporting bias)	High risk	Information about the protocol and the statistical analysis plan were not reported. Fatigue was reported using multiple eligible outcome measurements (scales, time points). Fatigue was reported in a format that was extractable for meta‐analysis. All outcomes that should be addressed (fatigue, cardiovascular disease, and death) were not reported
Other bias	Low risk	There was no evidence of different baseline characteristics, or different non‐randomised co‐interventions between groups. Funding was unlikely to influence the data analysis