Senanayake Sameera, Gunawardena Nalika, Palihawadana Paba, Bandara Palitha, Haniffa Rashan, Karunarathna R, Kumara Priyantha
Family Health Bureau, Colombo, Sri Lanka.
World Health Organization, Colombo, Sri Lanka.
BMC Nephrol. 2017 Jul 10;18(1):228. doi: 10.1186/s12882-017-0638-y.
Physical and psychological symptoms are among main manifestations of Chronic Kidney Disease (CKD). This study aimed to assess the symptom burden and self-perceived severity of symptoms among CKD patients living in a district in Sri Lanka.
A community based cross-sectional study included a sample of randomly selected 1174 CKD patients from all 19 Medical Officer of Health areas in the district of Anuradhapura. Trained para-medical staff visited the households and administered the locally validated questionnaire to assess the presence and severity of symptoms. The inquiry was on 25 symptoms in a 5 point Likert scale indicating the severity during the previous week. Symptom burden score was constructed by summing each symptom severity score which ranged from 0 to 125.
A total of 1118 CKD patients participated with a response rate of 95.2%. The mean age was 58.3 (SD 10.8) years and 62.7% were males. A majority were in CKD stage 4 (58.3%). Bone/joint pain was the most experienced symptom (87.6%; 95%CI 85.6-89.5). Loss of libido was the most severe symptom. The median symptom burden score was 35.0 (IQR 20.0-50.0). Multiple linear regression revealed education up to Advanced Level (β -9.176), CKD stage V (β 3.373), being dialyzed (β 20.944), comorbidities (β 4.241) and being employed (β -9.176) to be significant predictors of symptom burden.
Patients in all stages of CKD experience high symptom burden warranting rigorous measures to relieve symptoms and to improve the well-being of CKD patients.
身体和心理症状是慢性肾脏病（CKD）的主要表现之一。本研究旨在评估斯里兰卡某地区CKD患者的症状负担及自我感知的症状严重程度。
一项基于社区的横断面研究，从阿努拉德普勒区的19个卫生医疗官辖区中随机抽取了1174例CKD患者作为样本。经过培训的辅助医务人员走访这些家庭，并使用经过本地验证的问卷来评估症状的存在及严重程度。询问内容涉及25种症状，采用5级李克特量表来表明前一周的症状严重程度。症状负担得分通过将每个症状严重程度得分相加得出，范围为0至125分。
共有1118例CKD患者参与研究，应答率为95.2%。平均年龄为58.3（标准差10.8）岁，男性占62.7%。大多数患者处于CKD 4期（58.3%）。骨/关节疼痛是最常出现的症状（87.6%；95%置信区间85.6 - 89.5）。性欲减退是最严重的症状。症状负担得分的中位数为35.0（四分位间距20.0 - 50.0）。多元线性回归显示，高等教育程度（β -9.176）、CKD 5期（β 3.373）、接受透析治疗（β 20.944）、合并症（β 4.241）以及就业情况（β -9.176）是症状负担的显著预测因素。
CKD各阶段的患者都承受着较高的症状负担，需要采取严格措施来缓解症状并改善CKD患者的健康状况。
