Leicester Kidney Lifestyle Team, Department of Health Sciences, University of Leicester, Leicester, UK.
Leicester NIHR Biomedical Research Centre, Leicester, UK.
BMC Nephrol. 2021 Apr 22;22(1):147. doi: 10.1186/s12882-021-02355-5.
Those living with kidney disease (KD) report extensive symptom burden. However, research into how symptoms change across stages is limited. The aims of this study were to 1) describe symptom burden across disease trajectory, and 2) to explore whether symptom burden is unique to KD when compared to a non-KD population.
Participants aged > 18 years with a known diagnosis of KD (including haemodialysis (HD) and peritoneal dialysis (PD)) and with a kidney transplant) completed the Leicester Kidney Symptom Questionnaire (KSQ). A non-KD group was recruited as a comparative group. Multinominal logistic regression modelling was used to test the difference in likelihood of those with KD reporting each symptom.
In total, 2279 participants were included in the final analysis (age 56.0 (17.8) years, 48% male). The main findings can be summarised as: 1) the number of symptoms increases as KD severity progresses; 2) those with early stage KD have a comparable number of symptoms to those without KD; 3) apart from those receiving PD, the most frequently reported symptom across every other group, including the non-KD group, was 'feeling tired'; and 4) being female independently increased the likelihood of reporting more symptoms.
Our findings have important implications for patients with KD. We have shown that high symptom burden is prevalent across the spectrum of disease, and present novel data on symptoms experienced in those without KD. Symptoms requiring the most immediate attention given their high prevalence may include pain and fatigue.
The study was registered prospectively as ISRCTN11596292 .
患有肾脏疾病(KD)的患者报告存在广泛的症状负担。然而,关于症状在各阶段变化的研究有限。本研究的目的是:1)描述疾病轨迹中的症状负担,2)探讨与非 KD 人群相比,KD 患者的症状负担是否具有独特性。
纳入年龄>18 岁且已知 KD(包括血液透析(HD)和腹膜透析(PD)和肾移植)诊断的患者,并完成莱斯特肾脏症状问卷(KSQ)。招募非 KD 组作为对照组。使用多项逻辑回归模型来检验 KD 患者报告每种症状的可能性的差异。
共有 2279 名参与者被纳入最终分析(年龄 56.0(17.8)岁,48%为男性)。主要发现可总结为:1)随着 KD 严重程度的进展,症状数量增加;2)处于早期 KD 的患者与非 KD 患者具有相似数量的症状;3)除 PD 患者外,每个组(包括非 KD 组)报告最多的症状是“疲倦感”;4)女性独立增加了报告更多症状的可能性。
我们的研究结果对 KD 患者具有重要意义。我们表明,高症状负担在疾病谱中普遍存在,并提供了非 KD 患者所经历症状的新数据。鉴于其高患病率,需要立即关注的症状可能包括疼痛和疲劳。
该研究前瞻性地在 ISRCTN 注册(ISRCTN84543166)。