Symptom Burden Clustering in Chronic Kidney Disease Stage 5

Abstract

Patients with chronic kidney disease (CKD) Stage 5, experience multiple symptoms that negatively affect the health-related quality of life (HRQoL). This study examined the cluster of symptoms and their association with disease severity and comorbidities. The study sample included 123 patients with CKD Stage 5; 60 patients were in the dialysis group and 63 patients in the Conservative Kidney Management group. Symptom data were collected using the Spanish modified version of Palliative Care Outcome Scale-Symptoms (POS-S) Renal, a validated questionnaire to assess symptoms in this population. More than half of the patients described weakness, difficulty sleeping, and feeling depressed. Two symptom clusters were identified. There was no significant statistical correlation between disease severity and symptoms and between comorbidities and symptoms. The tendency of these symptoms to occur together has implications for improving symptom management in this population. Routine symptom assessment can be useful in clinical and research settings.

<p>Symptom Clusters in Patients with End-Stage Renal Disease Undergoing Hemodialysis</p>

“…The gastrointestinal cluster consists of five symptoms which are constipation, nausea, vomiting, diarrhoea, and decreased appetite. This cluster was reported in a prior study in Spain 4 and Taiwan. 9 The vomiting and nausea symptom might be caused by various influences such as insufficient dialysis, drug side effect, and abnormal BUN level.…”

“…2 HD can prolong lives, but patients may suffer from physical and psychological symptoms caused by disease progression or treatment. 3 , 4 …”

Symptom Cluster Science in Chronic Kidney Disease: A Literature Review

“…Six studies included patients on peritoneal dialysis (PD) Almutary, Douglas, & Bonner, 2017; Almutary, Douglas, & Bonner, 2016; Amro et al, 2014; Amro et al, 2015; Gutiérrez Sánchez, Leiva-Santos, & Cuesta-Vargas, 2017; Thong et al, 2009). Four analyses included patients who were being conservatively managed and not yet on dialysis (Almutary et al, 2017; Almutary, Douglas, & Bonner, 2016; Gutiérrez Sánchez et al, 2017; Lee & Jeon, 2015). Three analyses examined symptom clusters in patients with CKD Stages 2 to 4 (Almutary, Bonner, & Douglas, 2016; Almutary, Douglas et al, 2016; Lee & Jeon, 2015).…”

“…Amro et al used a longitudinal design that resulted in three data analyses (Amro et al, 2014; Amro et al, 2015; Amro et al, 2016). Four studies used the theory of unpleasant symptoms (TOUS) as a theoretical framework (Almutary, Douglas, & Bonner, 2016; Gutiérrez Sánchez et al, 2017; Jablonski, 2007). Ten analyses explored associations between symptom clusters and demographic and/or clinical variables and patient outcomes (Almutary et al, 2017; Amro et al, 2014; Amro et al, 2015; Amro et al, 2016; Curtin, Bultman, Thomas-Hawkins, Walters, & Schatell, 2002; Jablonski, 2007; Lee & Jeon, 2015; Shim & Cho, 2018; Thong et al, 2009; Yu, Huang, & Tsai, 2012).…”

Kidney symptom questionnaire: Development, content validation and relationship with quality of life

“…Patients with chronic kidney disease (CKD) typically experience a range of symptoms, including fatigue, weakness, musculoskeletal pain, sleep problems, low libido and skin discomfort (Brown et al 2017;Gutierrez Sanchez et al 2017;Pugh-Clarke et al 2017;Senanayake et al 2017;van der Veer et al 2017). Symptom burden is an important predictor of quality of life (QoL) (Almutary et al 2013;Almutary et al 2017), which can be reduced even in earlier stages of CKD (Cruz et al 2011).…”