Trajectories of CKD Symptoms May Predict Later Health Outcomes

MONDAY, Oct. 31, 2022 (HealthDay News) — Distinct trajectories of chronic kidney disease (CKD) may predict subsequent health outcomes, according to a study published online Oct. 28 in the Clinical Journal of the American Society of Nephrology.

Moustapha Faye, M.D., from CHRU-Nancy in France, and colleagues aimed to identify subgroups within the five-year trajectories of symptom evaluation among 2,787 participants with estimated glomerular filtration rate <60 mL/min/1.73 m² enrolled in the CKD-Renal Epidemiology and Information Network (CKD-REIN) cohort study from July 2013 to May 2016. Symptoms were assessed annually and 9,121 measures were reported over follow-up.

The researchers found that the prevalence of symptoms ranged from 24 percent for chest pain to 83 percent for fatigue; at least one symptom was reported by 98 percent of participants. Overall, 690 patients initiated kidney replacement therapy (KRT) and 490 died before initiating KRT after a median follow-up of 5.3 years. Two profiles of symptoms trajectories were identified: worse symptom score and worsening trajectory, which was characterized by a low initial symptoms score that worsened more than 10 points over time, a better symptom score, and a stable trajectory (31 and 69 percent, respectively). More risk factors for CKD progression at baseline, worse quality of life, and a higher risk of KRT and death before KRT were seen for participants in the worse symptom score and worsening trajectory group compared with other participants.

“It is possible to actively monitor symptoms and classify patients according to their progression,” Faye said in a statement. “This active symptom tracking will allow early therapeutic interventions to be planned to help manage different symptoms.”

CKD-REIN has been supported by a public-private partnership with several pharmaceutical companies. Several authors disclosed financial ties to these and other pharmaceutical companies.

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