CKD Symptom Burden Is High at All Stages

Individuals with stages 1 to 5 chronic kidney disease (CKD) who do not require renal replacement therapy (RRT) often have a high symptom burden and an impaired quality of life, according to a recent study.

A high symptom burden has been reported in previous studies among individuals with end-stage renal disease (ESRD). However, less is currently known about symptom burden and quality of life in patients with earlier stages of CKD.
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To explore this further, the researchers evaluated the CKD-related symptoms of 283 participants with stages 1 to 5 CKD. Mean participant age was 60.5 years, and mean estimated glomerular filtration rate (eGFR) was 38 ml/min/1.73 m².

Participants were administered the Leicester Uremic Symptom Score (LUSS) in order to assess the frequency and intrusiveness of 11 symptoms that are often reported in patients with kidney disease.

Results indicated that 96% of participants in this cohort had experienced at least 1 symptom. The median number of symptoms was 6. The most commonly reported symptoms were excessive tiredness (81%), sleep disturbance (70%), and bone and joint pain (69%).

The researchers noted that there had been few significant associations between biochemical markers of disease severity and symptom burden. Additionally, men in this cohort had reported fewer symptoms than women. Older patients found musculoskeletal symptoms to be the most intrusive, while younger patients found reduced concentration to be the most intrusive.

“Our findings suggest that patients with CKD stages 1-5 experience a multitude of symptoms that could potentially impact [quality of life],” the researchers concluded. “Using multidimensional tools like the LUSS, more exploration and focus could provide a greater opportunity for patient focused symptom control from the earliest stages of CKD.”

—Christina Vogt

Reference:

Brown SA, Tyrer FC, Clarke AL, et al. Symptom burden in patients with chronic kidney disease not requiring renal replacement therapy. Clin Kidney J. 2017;10(6):788-796. https://doi.org/10.1093/ckj/sfx057.