Symptom Burden Increases in Year Before Dialysis Initiation

TUESDAY, Nov. 15, 2022 (HealthDay News) — For older adults with kidney failure, symptom burden worsens in the year before initiation of dialysis and stabilizes thereafter, according to a study published online Nov. 10 in the Clinical Journal of the American Society of Nephrology.

Esther N.M. de Rooij, M.D., from the Leiden University Medical Center in the Netherlands, and colleagues examined the course of total and individual symptom number and burden before and after starting dialysis in patients aged 65 years and older from the European Quality study with an incident estimated glomerular filtration rate ≤20 mL/min/1.73 m². Thirty symptoms were assessed every six months between 2012 and 2021 using the dialysis symptom index (DSI). Data were included for 456 incident dialysis patients who completed at least one DSI in the year before or after dialysis.

The researchers found that symptom number increased +3.6 and symptom burden increased +13.3 in the year before dialysis initiation. In the year after, symptom number and burden decreased −0.9 and −5.9, respectively. The highest prevalence of symptoms was seen for “fatigue” (81 percent), “decreased interest in sex” (69 percent), and “difficulty becoming sexually aroused” (68 percent) at dialysis initiation, with burdens of 2.7, 2.4, and 2.3, respectively. After dialysis initiation, “fatigue” improved somewhat, while there was a further increase in the prevalence and burden of sexual symptoms.

“These results could help informing older patients with kidney failure who decided to start dialysis on what to expect regarding the development of their symptom burden,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

Abstract/Full Text