Symptoms like nausea, fatigue may be more common with severe CKD, in certain patients
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Key takeaways:
- Patients with severe chronic kidney disease were “very much” to “extremely” bothered by numerous symptoms.
- Overall, 23% of patients in the study reported muscle soreness.
Symptoms like poor appetite, nausea and stress may be more common with severe chronic kidney disease and reduce quality of life in patients not on dialysis, data show.
“Symptom recognition and management in CKD remains suboptimal. Health care professionals often underestimate the symptom burden of their patients,” Elodie Speyer, PhD, of the Center for Research in Epidemiology and Population Health in France, wrote with colleagues. Still, they added, “Research into symptoms experienced by patients with CKD has tended to focus on those receiving chronic dialysis for end-stage kidney failure.”
In a cross-sectional study, researchers in Brazil, France and the United States aimed to assess the impact of symptom prevalence and burden on quality of life in patients with moderate to severe CKD not requiring dialysis. Overall, 4,430 patients with CKD stages 3 through 5 were enrolled in the international CKD outcomes and practice patterns study.
The cohort, with a mean age of 68 years and mean 30 mL/min/1.73 m2 eGFR, reported and ranked symptoms from a standard questionnaire, and was followed from 2013 to 2021.
Outcomes included the physical and mental components of symptom burden on patients.
Patients were “very much” to “extremely” bothered by numerous symptoms, the data showed. Of those affected, 23% of patients reported soreness in muscles; 21% said they felt washed out or drained; and between 14% and 17% had cramps, shortness of breath, dry skin, a diminished sex life, or numbness in hands or feet, according to Speyer and colleagues.
The adjusted prevalence of cramps, fatigue, lack of appetite, nausea and sex life were greater with more severe CKD, and, except for sex life, higher in women.
Researchers found a high overall symptom burden was likelier in France, in women and in patients with albuminuria and comorbidities. The same was not true for patients with a lower eGFR.
In addition, patients with a high symptom burden had lower physical and mental component summary scores vs. those with a low burden. Physical scores were 13.4 points lower for patients with a high symptom burden. Mental scores were 7.7 points lower.
The findings highlight an urgency “to assess symptoms more systematically and to enhance provider/patient communication as part of [non-dialysis CKD] care aiming to improve patients’ quality of life and prioritized clinical outcomes,” the researchers wrote.
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