When people with varying degrees of chronic kidney disease not on dialysis answered annual questionnaires about their symptoms, the researchers found that a third could be classified as having ” Worse symptom scores and worse trajectories” of symptoms. As reported in Clinical Journal of the American Society of NephrologyThese patients are at particularly high risk of later needing dialysis and dying before dialysis is started.
For the study, Moustapha Faye, MD (CHRU Nancy, Université Cheikh Anta Diop de Dakar) and his colleagues, the investigators of the CKD-REIN cohort study, assessed symptoms annually using tables. The Quality of Life-36 questionnaire on Kidney Disease was completed by 2,787 adults in France with CKD without dialysis.
The prevalence of each symptom ranges from 24% (chest) to 83% (fatigue), and 98% of participants reported having at least one symptom. After a mean follow-up of 5.3 years, 690 participants started renal replacement therapy (KRT) as dialysis, and 490 died before KRT. The team identified two profiles of symptom trajectories: “Worse symptom scores and worse trajectories” in 31% of participants, which were characterized by low baseline symptom scores and worsened by 10 points (on a scale of 0–100) over time, and “Better symptom scores and stable trajectory” in 69% of participants, characterized by high baseline scores and remain stable over time.
Participants in the category “Worse Symptom Score and Worse Trajectory” had more Risk factors CKD progression at baseline, poorer quality of life, and higher risk of KRT and pre-KRT mortality than other participants.
“In addition to the existing CKD classifications, it is possible to proactively monitor symptoms and categorize patients according to their progression,” says Dr. This monitoring requires the participation of doctors and patients. “This active symptom monitoring will enable early treatment intervention planning to help manage various symptoms.”
An accompanying editorial notes that “in addition to disease management, Faye et al. provide further evidence of the need to be concerned with discomfort. symptom that causes suffering and affects the lives of end-stage CKD patients. “
The paper was titled “5-year symptom trajectories in patients with non-dialysis-dependent chronic kidney disease” and the editorial was titled “Can we rotate the symptom curve? Trajectories and outcomes symptomatic outcomes in patients with CKD.” Both will appear online on October 28, 2022 in Clinical Journal of the American Society of Nephrology.
5-year symptom trajectory in patients with non-dialysis-dependent chronic kidney disease, Clinical Journal of the American Society of Nephrology (In 2022). DOI: 10.2215 / CJN.06140522
Can we invert the symptom curve? Trajectories and symptom outcomes in CKD patients, Clinical Journal of the American Society of Nephrology (In 2022). DOI: 10.2215 / CJN.11240922
American Society of Nephrology
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