Which patients with chronic kidney disease have the greatest symptom burden? A comparative study of advanced CKD stage and dialysis modality

Almutary, Hayfa, Bonner, Ann and Douglas, Clint (2016) Which patients with chronic kidney disease have the greatest symptom burden? A comparative study of advanced CKD stage and dialysis modality. Journal of Renal Care, 42 2: 73-82. doi:10.1111/jorc.12152


Author Almutary, Hayfa
Bonner, Ann
Douglas, Clint
Title Which patients with chronic kidney disease have the greatest symptom burden? A comparative study of advanced CKD stage and dialysis modality
Journal name Journal of Renal Care   Check publisher's open access policy
ISSN 1755-6686
1755-6678
Publication date 2016-06
Year available 2016
Sub-type Article (original research)
DOI 10.1111/jorc.12152
Open Access Status Not Open Access
Volume 42
Issue 2
Start page 73
End page 82
Total pages 10
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2017
Language eng
Formatted abstract
Background: Chronic kidney disease (CKD) leads to a range of symptoms, which are often under-recognised and little is known about the multidimensional symptom experience in advanced CKD.

Objectives: To examine (1) symptom burden at CKD stages 4 and 5, and dialysis modalities, and (2) demographic and renal history correlates of symptom burden.

Methods: Using a cross-sectional design, a convenience sample of 436 people with CKD was recruited from three hospitals. The CKD Symptom Burden Index (CKD-SBI) was used to measure the prevalence, severity, distress and frequency of 32 symptoms. Demographic and renal history data were also collected.

Results: Of the sample, 75.5% were receiving dialysis (haemodialysis, n=287; peritoneal dialysis, n=42) and 24.5% were not undergoing dialysis (stage 4, n=69; stage 5, n=38). Participants reported an average of 13.01±7.67 symptoms. Fatigue and pain were common and burdensome across all symptom dimensions. While approximately one-third experienced sexual symptoms, when reported these symptoms were frequent, severe and distressing. Haemodialysis, older age and being female were independently associated with greater symptom burden.

Conclusions: In CKD, symptom burden is better understood when capturing the multidimensional aspects of a range of physical and psychological symptoms. Fatigue, pain and sexual dysfunction are key contributors to symptom burden, and these symptoms are often under-recognised and warrant routine assessment. The CKD-SBI offers a valuable tool for renal clinicians to assess symptom burden, leading to the commencement of timely and appropriate interventions.
Keyword Chronic kidney disease
Dialysis
Non-dialysis
Symptom burden
Symptom dimensions
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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