title: Symptom burden in chronic kidney disease: a review of recent literature.
abstract: BACKGROUND
  People living with chronic kidney disease (CKD) experience multiple symptoms due to both the disease and its treatment. However, these symptoms are often underrecognised. In addition, the majority of studies have focused on an individual symptom; however, these symptoms rarely occur in isolation and may instead occur in clusters.
  
  
  OBJECTIVE
  To investigate the total symptom burden in advanced CKD (Stages 4 and 5) and to identify the key instruments that are used to assess multiple symptoms.
  
  
  METHODS
  A literature search from 2006 to 2012 was undertaken and a total of 19 articles were included.
  
  
  RESULTS
  The most common CKD symptoms were fatigue or lack of energy, feeling drowsy, pain and pruritus. However, symptom assessment instruments varied between studies, often with inconsistent or inadequate symptom dimensions.
  
  
  CONCLUSIONS
  People with CKD experience a high symptom burden, although little is known about the burden for people with CKD Stage 4 and for those with CKD Stage 5 receiving peritoneal dialysis. This review recommends that a full range of symptoms be assessed for those at different stages of CKD. Improved understanding of the burden of symptoms can be used as the basis for treatment choices and for identifying priorities which are likely to contribute to a better quality of life and improve the quality of care.
authors.affiliation: School of Nursing, Queensland University of Technology, Kelvin Grove, QLD, Australia. donahez@hotmail.com
authors.forename: Hayfa
authors.initials: H
authors.lastname: Almutary
authors.forename: Ann
authors.initials: A
authors.lastname: Bonner
authors.forename: Clint
authors.initials: C
authors.lastname: Douglas
mesh_terms: D017281:Cost of Illness; D003430:Cross-Sectional Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000145:classification / Q000451:nursing* / Q000628:therapy; D008137:Longitudinal Studies; D009730:Nursing Assessment; D010530:Peritoneal Dialysis / Q000451:nursing; D011379:Prognosis; D011787:Quality of Health Care; D011788:Quality of Life / Q000523:psychology; D063189:Symptom Assessment / Q000451:nursing
keywords: Chronic kidney disease; Symptom burden; Symptoms