title: WHICH PATIENTS WITH CHRONIC KIDNEY DISEASE HAVE THE GREATEST SYMPTOM BURDEN? A COMPARATIVE STUDY OF ADVANCED CKD STAGE AND DIALYSIS MODALITY.
abstract: BACKGROUND
  Chronic kidney disease (CKD) leads to a range of symptoms, which are often under-recognised and little is known about the multidimensional symptom experience in advanced CKD.
  
  
  OBJECTIVE
  To examine (1) symptom burden at CKD stages 4 and 5, and dialysis modalities, and (2) demographic and renal history correlates of symptom burden.
  
  
  METHODS
  Using a cross-sectional design, a convenience sample of 436 people with CKD was recruited from three hospitals. The CKD Symptom Burden Index (CKD-SBI) was used to measure the prevalence, severity, distress and frequency of 32 symptoms. Demographic and renal history data were also collected.
  
  
  RESULTS
  Of the sample, 75.5 % were receiving dialysis (haemodialysis, n = 287; peritoneal dialysis, n = 42) and 24.5 % were not undergoing dialysis (stage 4, n = 69; stage 5, n = 38). Participants reported an average of 13.01 ± 7.67 symptoms. Fatigue and pain were common and burdensome across all symptom dimensions. While approximately one-third experienced sexual symptoms, when reported these symptoms were frequent, severe and distressing. Haemodialysis, older age and being female were independently associated with greater symptom burden.
  
  
  CONCLUSIONS
  In CKD, symptom burden is better understood when capturing the multidimensional aspects of a range of physical and psychological symptoms. Fatigue, pain and sexual dysfunction are key contributors to symptom burden, and these symptoms are often under-recognised and warrant routine assessment. The CKD-SBI offers a valuable tool for renal clinicians to assess symptom burden, leading to the commencement of timely and appropriate interventions.
authors.affiliation: King Abdulaziz University, Saudi Arabia.|School of Nursing, Queensland University of Technology, Queensland, Australia.|Chronic Kidney Disease Centre for Research Excellence, University of Queensland, Brisbane, Australia.
authors.forename: Hayfa
authors.initials: H
authors.lastname: Almutary
authors.affiliation: School of Nursing, Queensland University of Technology, Queensland, Australia.|Chronic Kidney Disease Centre for Research Excellence, University of Queensland, Brisbane, Australia.|Visiting Research Fellow, Renal Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia.
authors.forename: Ann
authors.initials: A
authors.lastname: Bonner
authors.affiliation: School of Nursing, Queensland University of Technology, Queensland, Australia.
authors.forename: Clint
authors.initials: C
authors.lastname: Douglas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003956:Dialysis / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012529:Saudi Arabia; D012720:Severity of Illness Index; D013577:Syndrome
keywords: Chronic kidney disease; Dialysis; Non-dialysis; Symptom burden; Symptom dimensions