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WHICH PATIENTS WITH CHRONIC KIDNEY DISEASE HAVE THE GREATEST SYMPTOM BURDEN? A COMPARATIVE STUDY OF ADVANCED CKD STAGE AND DIALYSIS MODALITY
Author(s) -
Almutary Hayfa,
Bonner Ann,
Douglas Clint
Publication year - 2016
Publication title -
journal of renal care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.381
H-Index - 27
eISSN - 1755-6686
pISSN - 1755-6678
DOI - 10.1111/jorc.12152
Subject(s) - medicine , kidney disease , dialysis , peritoneal dialysis , psychological intervention , physical therapy , disease burden , distress , intensive care medicine , disease , psychiatry , clinical psychology
SUMMARY 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.