Symptom Burden in Chronic Kidney Disease: A Review of Recent Literature

Abstract

People with CKD experience a high symptom burden, although little is known about the burden for people with CKD Stage 4 and for those with CKD Stage 5 receiving peritoneal dialysis. This review recommends that a full range of symptoms be assessed for those at different stages of CKD. Improved understanding of the burden of symptoms can be used as the basis for treatment choices and for identifying priorities which are likely to contribute to a better quality of life and improve the quality of care.

Symptoms and quality of life from patients undergoing hemodialysis in Switzerland

“…The patients in our study reported an average of 10 symptoms, which is in line with several other studies where the average number of symptoms reported ranged from 6 to 20. [8] More specifically, the comparison with our results against those obtained by Weisbord et al, [26] using identical instruments on Italian and American HD patients, shows that the average number of symptoms reported by Swiss patients was slightly greater than the average number reported by American patients (9), but less than the average number reported by Italian patients (14). Even if the general levels are consistent and remain high, context-related differences are evident and would need further investigation.…”

“…[25] Ten years ago, Weisbord [23] bemoaned the scant research geared to explore the prevalence and severity of selfperceived symptoms among HD patients and to evaluate their effect on QoL and depression. Almutary et al [8] reiterated this point more recently, underscoring the need to acquire a better understanding of symptom burden. In addition, Weisbord et al [26] found there were cultural differences regarding prevalence and severity of self-perceived symptoms among HD patients around the world.…”

“…[6] In this regard, authors [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] have pointed out that patients on chronic HD experience a multitude of symptoms, both physical and psychological, owing primarily to the trajectory of the kidney disease, to the different treatments received, and to their side effects. In a review of the recent literature on the topic, Almutary et al [8] mentioned that the mean number of symptoms per HD patient ranged from 6 to 20 across studies and that the main symptoms reported by CKD patients, including those on HD, were fatigue or lack of energy (81%), feeling drowsy (75%), pain (65%), pruritus (61%) and dry skin (57%). While the prevalence of physical symptoms is considerable, HD patients also experience symptoms of a psychological order, such as feeling sad, feeling irritable, and feeling nervous.…”

“…In Switzerland, despite the growing number of HD patients, no study has ever specifically explored the symptomatology of this population. Furthermore, Almutary et al [8] pointed out that research on the subject often lacked a theoretical basis, which constituted a shortcoming in terms of the choice of variables investigated and the proposed relationship between them. Against this background and drawing on Humphreys' theory of symptom management, [24] we undertook a study with a twofold objective: 1) to measure the prevalence and severity of physical and emotional symptoms among HD patients in Switzerland; and 2) to examine the relationship between symptom prevalence and severity and patient QoL.…”

Associations among Spirituality, Health-Related Quality of Life, and Depression in Pre-Dialysis Chronic Kidney Disease Patients: An Exploratory Analysis in Thai Buddhist Patients

“…The burdens imposed by the multiple symptoms of CKD from disease and treatment experienced by patients are well recognized [14]. Patient function limitations and QOL declination with disease progression are also well known [15,16].…”