Evaluation of physical symptoms in patients on peritoneal dialysis

Ana Elizabeth Figueiredo, Cate Goodlad, Michelle Clemenger, San San Haddoub, Jacqueline McGrory, Kim Pryde, Emma Tonkins, Nora Hisole, Edwina Anne Brown, Ana Elizabeth Figueiredo, Cate Goodlad, Michelle Clemenger, San San Haddoub, Jacqueline McGrory, Kim Pryde, Emma Tonkins, Nora Hisole, Edwina Anne Brown

Abstract

Introduction. Little is known about physical symptoms in peritoneal dialysis (PD) Patients. This study aims to determine the prevalence of symptoms (general and abdominal) in PD patients. Methods. A cross-sectional study, with subsequent followup, using an author-designed 21 symptoms questionnaire (15 nonabdominal and 6 abdominal). Each symptom was assessed on a scale 0-3 for severity (none-severe) and frequency (never-every day). Results. We studied 41 patients, mean age 60 ± 15 years, 56% male, 19.5% diabetics, and 51.5% on APD. Mean number of symptoms was 9.5 ± 3.9 and total symptoms score was 28.5 ± 12 with abdominal scores of 6.4 ± 4.8. Most frequent symptoms were lack of energy, itching, cramps, poor sleep, and loss of appetite. A second evaluation in 20 patients disclosed no statistical difference between the first and second assessments, or between subgroups. Cramps were the only symptoms which decreased over time (P = 0.120). Lack of energy did not correlate with haemoglobin, neither did itching with phosphate level. Conclusions. Physical symptoms are frequent and troublesome; they relate to advanced kidney disease and not specifically to PD. Symptoms remain stable over time and do not appear to relate to dialysis parameter markers.

References

    1. Abdel-Kader K, Unruh ML, Weisbord SD. Symptom burden, depression, and quality of life in chronic and end-stage kidney disease. Clinical Journal of the American Society of Nephrology. 2009;4(6):1057–1064.
    1. Weisbord SD, Fried LF, Mor MK, et al. Renal provider recognition of symptoms in patients on maintenance hemodialysis. Clinical Journal of the American Society of Nephrology. 2007;2(5):960–967.
    1. Weisbord SD, Fried LF, Arnold RM, et al. Development of a symptom assessment instrument for chronic hemodialysis patients: the dialysis symptom index. Journal of Pain and Symptom Management. 2004;27(3):226–240.
    1. Davison SN, Jhangri GS, Johnson JA. Longitudinal validation of a modified Edmonton symptom assessment system (ESAS) in haemodialysis patients. Nephrology Dialysis Transplantation. 2006;21(11):3189–3195.
    1. Danquah FV, Zimmerman L, Diamond PM, Meininger J, Bergstrom N. Frequency, severity, and distress of dialysis-related symptoms reported by patients on hemodialysis. Nephrology Nursing Journal. 2010;37(6):627–639.
    1. Kutner NG, Jassal SV. Quality of life and rehabilitation of elderly dialysis patients. Seminars in Dialysis. 2002;15(2):107–112.
    1. Kimmel PL, Emont SL, Newmann JM, Danko H, Moss AH. ESRD patient quality of life: symptoms, spiritual beliefs, psychosocial factors, and ethnicity. American Journal of Kidney Diseases. 2003;42(4):713–721.
    1. Kimmel PL. Psychosocial factors in adult end-stage renal disease patients treated with hemodialysis: correlates and outcomes. American Journal of Kidney Diseases. 2000;35(4, supplement 1):S132–S140.
    1. Brown EA, Johansson L, Farrington K, et al. Broadening Options for Long-term Dialysis in the Elderly (BOLDE): differences in quality of life on peritoneal dialysis compared to haemodialysis for older patients. Nephrology, Dialysis, Transplantation. 2010;25(11):3755–3763.
    1. Murtagh FEM, Addington-Hall J, Higginson IJ. The prevalence of symptoms in end-stage renal disease: a systematic review. Advances in Chronic Kidney Disease. 2007;14(1):82–99.
    1. Williams ME. Diabetic CKD/ESRD 2010: a progress report? Seminars in Dialysis. 2010;23(2):129–133.
    1. Davison SN. Pain in hemodialysis patients: prevalence, cause, severity, and management. American Journal of Kidney Diseases. 2003;42(6):1239–1247.
    1. Thong MSY, van Dijk S, Noordzij M, et al. Symptom clusters in incident dialysis patients: associations with clinical variables and quality of life. Nephrology Dialysis Transplantation. 2009;24(1):225–230.
    1. Rocco MV, Gassman JJ, Wang SR, Kaplan RM. Cross-sectional study of quality of life and symptoms in chronic renal disease patients: the Modification of Diet in Renal Disease Study. American Journal of Kidney Diseases. 1997;29(6):888–896.
    1. Mollaoglu M. Fatigue in people undergoing hemodialysis. Dialysis and Transplantation. 2009;38(6):216–220.
    1. Liu HE. Fatigue and associated factors in hemodialysis patients in Taiwan. Research in Nursing and Health. 2006;29(1):40–50.
    1. Weisbord SD, Fried LF, Arnold RM, et al. Prevalence, severity, and importance of physical and emotional symptoms in chronic hemodialysis patients. Journal of the American Society of Nephrology. 2005;16(8):2487–2494.
    1. Meira FS, Figueiredo AE, Zemiarcki J, Pacheco J, Poli-de-Figueiredo CE, D’Avila DO. Two variable sodium profiles and adverse effects during hemodialysis: a randomized crossover study. Therapeutic Apheresis and Dialysis. 2010;14(3):328–333.
    1. Donauer J. Hemodialysis-induced hypotension: impact of technologic advances. Seminars in Dialysis. 2004;17(5):333–335.
    1. Sherman RA. Modifying the dialysis prescription to reduce intradialytic hypotension. American Journal of Kidney Diseases. 2001;38(4, supplement 4):S18–S25.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel