Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, P.O. Box 566, Irbid, 21163, Jordan.
Clinical Pharmacy Department, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
Int Urol Nephrol. 2020 May;52(5):959-967. doi: 10.1007/s11255-020-02458-2. Epub 2020 Apr 15.
This study investigated the clinical characteristics and symptomatology of ESRD patients in Jordan taking a multidimensional approach.
This was a cross-sectional study that included a cohort of 620 patients undergoing maintenance hemodialysis (HD). Data were retrieved via patient survey administration and electronic health records. A modified version of the Charlson Comorbidity index (CCI) was utilized to assess comorbidity. Symptoms were assessed using the validated Arabic version of the CKD Symptom Burden Index (CKD-SBI).
The mean (± SD) age of participants was 50.9 ± 16.1 years, with the 59.8% being males. Diabetes was the leading cause of kidney disease among patients (29.2%), followed by hypertension (20.7%) and medication use (8.6%). Common comorbidities included hypertension (72.4%), diabetes (38.4%), and cardiovascular disease (18.7%). Patients experienced 13 CKD-related symptoms on average, with a total symptom burden score of 29.6. Muscle strain was the most common symptom (62.6%), followed by itchiness (59.7%), nervousness (57.7%), and anxiety (57.7%). Charlson comorbidity index (CCI) [β = 0.88, 95% CI (0.34-1.41)], male gender [β = - 5.59; 95% CI (- 8.34 to - 2.85)], higher educational level [β = - 3.38; 95% CI (- 6.39 to - 0.37)], and number of dialysis sessions/week (β = 6.22, 95% CI 3.37-9.07) were independent predictors of total symptom burden. Similarly, these factors predicted symptom troublesomeness, intensity, and recurrence.
A holistic clinical picture of ESRD that includes multidimensional symptom assessment is warranted for better disease management and resource allocation. Our paper identifies key characteristic of this population and factors contributing to total symptom burden.
本研究采用多维方法调查了约旦终末期肾病（ESRD）患者的临床特征和症状表现。
这是一项横断面研究，纳入了 620 名接受维持性血液透析（HD）的患者队列。通过患者问卷调查和电子健康记录获取数据。采用改良版 Charlson 合并症指数（CCI）评估合并症。使用经过验证的阿拉伯语版慢性肾脏病症状负担指数（CKD-SBI）评估症状。
参与者的平均（±标准差）年龄为 50.9±16.1 岁，其中 59.8%为男性。在患者中，糖尿病是导致肾脏疾病的主要原因（29.2%），其次是高血压（20.7%）和药物使用（8.6%）。常见合并症包括高血压（72.4%）、糖尿病（38.4%）和心血管疾病（18.7%）。患者平均经历 13 种与 CKD 相关的症状，总症状负担评分为 29.6。肌肉紧张是最常见的症状（62.6%），其次是瘙痒（59.7%）、紧张（57.7%）和焦虑（57.7%）。Charlson 合并症指数（CCI）[β=0.88，95%置信区间（0.34-1.41)]、男性[β=-5.59；95%置信区间（-8.34 至-2.85)]、较高的教育水平[β=-3.38；95%置信区间（-6.39 至-0.37)]和每周透析次数（β=6.22，95%置信区间 3.37-9.07)是总症状负担的独立预测因素。同样，这些因素预测了症状的困扰、强度和复发。
需要采用多维症状评估方法全面了解 ESRD 患者的临床情况，以更好地进行疾病管理和资源分配。我们的论文确定了该人群的关键特征和导致总症状负担的因素。
