Gomariz-Ruiz Jaime, Pérez-Cruzado David, Gutiérrez-Sánchez Daniel
Faculty of Health Sciences, University of Málaga, 29071, Málaga, Spain.
Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, 29071, Málaga, Spain.
Heliyon. 2024 Dec 28;11(1):e41556. doi: 10.1016/j.heliyon.2024.e41556. eCollection 2025 Jan 15.
Chronic kidney disease is a global problem characterized by a progressive decrease in kidney function with associated symptoms. A better understanding of these symptoms could lead to the development of personalized strategies.
This systematic review aims to describe the clusters of symptoms in kidney failure and categorize them according to their time of onset and how disabling they are for patients.
A systematic review was carried out.
This systematic review was conducted according to the PRISMA declaration standards. The search engines used were initially limited to WOS, Embase, and PubMed, and they were employed between November 2022 and January 2023. In addition, the bibliographic search was supplemented with databases of the grey literature, such as OpenGrey, in May 2023. The following inclusion criteria were established: cross-sectional studies, studies on adult populations, and studies dealing with clusters of symptoms associated with kidney failure. Before an article was definitively selected, the checklist of the STROBE initiative, with a maximum of 22 points, was applied, assessing the quality of cross-sectional articles. Articles were selected independently and blinded by two researchers, and a third researcher was involved in case of disagreement.
After carrying out the bibliographic search, we found that eight articles, out of the 46 articles that were evaluated, fully met the inclusion criteria. Two tables were made, which include important information, such as the participants' profiles or the way the authors extracted a cluster of symptoms.
The main area for improvement is that it was not possible to perform a meta-analysis due to the methodology used in the articles analysed. Constraining the selection of articles to those written in Spanish or English could be a limitation as not all articles dealing with symptom clusters in kidney failure were considered.
Common symptoms in clusters of symptoms in kidney failure were nausea or vomiting (gastrointestinal problems), fatigue or muscle weakness (neuromuscular symptoms/problems), low interest in sex or difficulty feeling sexually excited (sexual symptoms), dry skin or skin itching (skin problems), lack of appetite, feeling squeezed, feeling weak or dizzy and difficulty breathing (uraemic), fatigue or muscle weakness (energy/vitality), and chest pain (cardiac-related problems). Providing treatment based on clusters of symptoms would benefit the patient more than providing treatment based on isolated symptoms. The identification of symptom clusters in kidney failure has clinical relevance, and this research could facilitate the development of adequate intervention strategies, simplifying the treatment offered to patients and even reducing the side effects of treatments.
慢性肾脏病是一个全球性问题，其特征是肾功能逐渐下降并伴有相关症状。更好地了解这些症状有助于制定个性化策略。
本系统评价旨在描述肾衰竭患者的症状群，并根据其发作时间以及对患者的致残程度进行分类。
进行了一项系统评价。
本系统评价按照PRISMA声明标准进行。最初使用的搜索引擎仅限于Web of Science（WOS）、Embase和PubMed，检索时间为2022年11月至2023年1月。此外，在2023年5月，通过OpenGrey等灰色文献数据库对文献检索进行了补充。制定了以下纳入标准：横断面研究、针对成年人群的研究以及涉及与肾衰竭相关症状群的研究。在最终选定一篇文章之前，应用了STROBE倡议的清单（满分22分）来评估横断面文章的质量。由两名研究人员独立且盲法筛选文章，如有分歧则由第三名研究人员参与。
在进行文献检索后，我们发现，在评估的46篇文章中，有8篇完全符合纳入标准。制作了两个表格，其中包括重要信息，如参与者的概况或作者提取症状群的方式。
主要的改进方向是，由于所分析文章使用的方法，无法进行荟萃分析。将文章选择限制在西班牙语或英语撰写的文章可能是一个局限性，因为并非所有涉及肾衰竭症状群的文章都被考虑在内。
肾衰竭症状群中的常见症状包括恶心或呕吐（胃肠道问题）、疲劳或肌肉无力（神经肌肉症状/问题）、性欲低下或性兴奋困难（性症状）、皮肤干燥或皮肤瘙痒（皮肤问题）、食欲不振、有压迫感、虚弱或头晕以及呼吸困难（尿毒症）、疲劳或肌肉无力（能量/活力）和胸痛（心脏相关问题）。基于症状群提供治疗比基于孤立症状提供治疗对患者更有益。识别肾衰竭中的症状群具有临床意义，这项研究有助于制定适当的干预策略，简化为患者提供的治疗，甚至减少治疗的副作用。
