Symptom Clusters in Hemodialysis : Insights From a Multicenter Analysis Using Tetrachoric Correlations

March 9, 2026 updated by: Calydial

In 2025, Guerraoui et al. published the Concordance Study in Clinical Kidney Journal, a large multicenter cross-sectional study embedded within the French REIN registry. This study compared symptoms reported by hemodialysis patients using the Dialysis Symptom Index (DSI) with clinician-perceived symptoms, revealing a high symptom burden and marked patient-clinician discordance [3].

The present work is a secondary analysis of the Concordance Study dataset. Building on the original findings, this analysis aims to deepen understanding of symptom organization and determinants in hemodialysis using multivariate and correlation-based approaches. Specifically, our objectives were :

  1. to identify and characterize symptom clusters using tetrachoric correlations and hierarchical clustering;
  2. to examine associations between symptoms (and clusters) and comorbidity burden, while assessing potential sex-specific patterns in symptom expression.

Through this secondary analysis, we aim to clarify the internal architecture of symptom co-occurrence, identify key demographic drivers such as sex, and generate evidence supporting cluster-informed, individualized approaches to symptom assessment and management in routine nephrology care.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Actual)

256

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • France
      • Lyon, France, 69000
        • CH Saint Joseph Saint Luc
      • Lyon, France, 69000
        • Hcl Edouard Herriot
      • Lyon, France, 69000
        • HCL Lyon Sud
      • Saint-Etienne, France, 42055
        • ARTIC42
      • Sallanches, France, 74700
        • CHAL
      • Vienne, France, 38200
        • CALYDIAL

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Hemodialysis patients in six dialysis centres and self-dialysis units in the Rhône-Alpes region of France

Description

Inclusion Criteria:

  • undergoing maintenance hemodialysis
  • ≥18 years
  • dialysis vintage ≥3 months

Exclusion Criteria:

  • patients with cognitive impairment (which was assessed with the presence of either clinical judgement or formal diagnosis)
  • patients who did not have the ability to express consent or refused to participant in the study
  • patients who could not read or understand French well enough to complete the questionnaire.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
identify and characterize symptom clusters
Time Frame: one day enrollment
identify and characterize symptom clusters using tetrachoric correlations and hierarchical clustering
one day enrollment
examine associations between symptoms (and clusters) and comorbidity burden
Time Frame: one day enrollment
examine associations between symptoms (and clusters) and comorbidity burden, while assessing potential sex-specific patterns in symptom expression
one day enrollment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Calydial

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2023

Primary Completion (Actual)

January 1, 2023

Study Completion (Actual)

December 31, 2024

Study Registration Dates

First Submitted

March 3, 2026

First Submitted That Met QC Criteria

March 9, 2026

First Posted (Actual)

March 11, 2026

Study Record Updates

Last Update Posted (Actual)

March 11, 2026

Last Update Submitted That Met QC Criteria

March 9, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • Symptom Clusters in HD

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

all IPD collected

IPD Sharing Time Frame

Beginning 3 months and ending 3 years after the publication of results

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF
  • CSR

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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