JY MAH1, M DAMASIEWICZ1,2, P KERR1,2, K LINTON1
1Department of Nephrology, Monash Health, Monash Medical Centre Clayton, Clayton, Australia, 2Department of Medicine, Monash University, Clayton, Australia
Aim: To investigate the symptom burden in a cohort of near and end-stage kidney disease patients (ESKD) in a large tertiary renal network, to highlight care priorities and guide resource allocation.
Background: Patients with near and ESKD have a significant symptom burden, and high morbidity and mortality when compared to similarly aged individuals without kidney disease. The symptom burden in these patients remains poorly documented. The POS-S Renal questionnaire is a patient reported outcome measure developed to evaluate the symptom burden in this cohort. It consists of 17 symptoms and 2 additional questions graded from 0 (not at all) to 4 (overwhelmingly).
Methods: 585 patients completed 1449 POS-S questionnaires over a 12-month period in the renal failure clinic at Monash Medical Centre, with a completion rate of 77%. The first completed questionnaire for each patient was used in the analysis.
Results:51% of patients were aged between 60-79, 67% were male, and 90% had Stage 4-5D CKD. The most common symptoms experienced at any severity were weakness/lack of energy 72% (40% moderate to overwhelming), poor mobility 53%, difficulty sleeping 53%, shortness of breath 49% and drowsiness 49%. Symptoms more commonly associated with ESKD such as nausea, vomiting, poor appetite, itching and constipation had a lower prevalence of 32%, 15%, 42%, 48% and 38% respectively. The mean POS-S Renal Scores were not significantly different between younger and older patients.
Conclusions: The main symptoms in this cohort were weakness and lack of energy, poor sleep and poor mobility. These were equally prevalent in younger and older patients. More research is needed to develop targeted strategies to mitigate these symptoms in near ESKD and ESKD cohorts.
Professor Peter Kerr is the Director of Nephrology at Monash Health. He is a Council Member of the ISN and APSN, and a former Editor-in-Chief of “Nephrology”. He maintains a strong research interest in numerous areas of nephrology, most notably haemodialysis and home based therapies.