How does symptom burden differ in people with advanced CKD who are non-dialysis or currently receiving dialysis?

Almutary, Hayfa, Bonner, Ann, & Douglas, Clint (2014) How does symptom burden differ in people with advanced CKD who are non-dialysis or currently receiving dialysis? In Annual Scientific Meeting of the ANZSN & Renal Society of Australasia Annual Conference, 25-27 August 2014, Melbourne, Australia.

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Chronic kidney disease (CKD) leads to a range of symptoms which are often under-recognised. Little is known about the full range of symptoms, particularly in who are pre-dialysis. Understanding symptom prevalence, distress, severity and frequency will help prioritise symptom management.


To examine symptom burden in advanced CKD (stages 4 and 5) and compare the symptom experience between those receiving dialysis or those who are pre-dialysis.


Using a cross-sectional design, a convenience sample of 436 people from three hospitals completed the Modified Dialysis Symptom Index (MDSI). Demographic and renal history data was also collected. Based on the 32 symptoms, we compared the prevalence, severity, distress and frequency of each symptom by treatment modality.


Mean age was 48 years (range 18-87 years) and 53% were male. 75.5% (haemodialysis = 287; peritoneal dialysis = 42) were receiving dialysis and 24.5% (n = 107) were pre-dialysis. Overall, the mean symptom prevalence was 12.6 ± 7.9 and the most prevalent symptoms were fatigue (77%), bone or joint pain (60.3%) and itching (59.6%) across all CKD groups. The distress, severity and frequency of the symptoms were higher in the dialysis group. However, a higher frequency of psychological symptoms (worrying, feeling nervous and depression) were reported in the pre-dialysis group.

Implication for clinical practice

Patients with advanced CKD have a high symptom burden with those who are pre-dialysis needing greater psychological support. The MDSI could be used in nursing practice to screen patients for symptoms which could lead to timely and appropriate interventions.

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ID Code: 84785
Item Type: Conference Item (Presentation)
Refereed: No
Additional URLs:
Keywords: chronic kidney disease, symptom, stage 4 and 5, assessment, management
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Schools > School of Nursing
Copyright Owner: Copyright 2014 [please consult the authors]
Deposited On: 14 Jun 2015 23:29
Last Modified: 21 Jun 2015 00:28

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