Study shows change in symptoms before and after starting dialysis in older patients with kidney failure

Study shows change in symptoms before and after starting dialysis in older patients with kidney failure

In a study published in CJASN that included older adults with kidney failure, symptoms related to their condition worsened in the year before patients began dialysis but stabilized after dialysis began.

For older people with kidney failure, reducing their symptom burden can help improve their quality of life. By analyzing data from the European Quality (EQUAL) study, an ongoing prospective multicenter study in patients aged 65 years and older with advanced chronic kidney disease, Esther NM de Rooij, MD (Leiden University Medical Center, in the Netherlands) and her colleagues examined the course of total and individual symptom counts and burden before and after dialysis initiation 456 patients with kidney failure. Between 2012 and 2021, 30 symptoms were assessed every 3 to 6 months, with symptom number scores ranging from 0 to 30 and symptom burden scores ranging from 0 to 150 (with higher scores indicating greater severity).

Initiation of dialysis may affect individual symptoms related to kidney failure differently. However, the change in symptoms before and after starting dialysis in older patients has not been studied so far.”

Dr. Esther NM de Rooij, MD, Leiden University Medical Center, in the Netherlands

The analysis showed that in the year before starting dialysis, the number of symptoms increased by +3.6 and the symptom burden increased by +13.3. In the following year, the number of symptoms fell by -0.9 and the burden by -5.9. At dialysis initiation, “fatigue,” “decreased interest in sex,” and “difficulty becoming sexually aroused” had the highest prevalence of 81%, 69%, and 68%, with a burden of 2.7, 2.4, and 2.3, respectively. “Fatigue” improved somewhat after starting dialysis, while the prevalence and burden of sexual symptoms continued to increase.

“We hope that these results can help inform older patients with kidney failure who decide to start dialysis about what to expect regarding the evolution of their symptom burden,” said Dr. de Rooij.

Additional study authors are Yvette Meuleman, PhD, Johan W. de Fijter, MD, PhD, Kitty J. Jager, MD, PhD, Nicholas C. Chesnaye, PhD, Marie Evans, MD, PhD, Fergus J. Caskey, MD, Claudia Torino, PhD, Gaetana Porto, MSc, Maciej Szymczak, MD, PhD, Christiane Drechsler, MD, PhD, Christoph Wanner, MD, PhD, Friedo W. Dekker, MD, PhD, and Ellen K. Hoogeveen, MD, PhD.

Source:

American Society of Nephrology

Reference:

de Rooij, ENM, et al. (2022) Symptom burden before and after starting dialysis in older patients. Clinical Journal of the American Society of Nephrology. doi.org/10.2215/CJN.09190822.

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