Kidney Week

Abstract: TH-PO298

The Symptom Profile of Hemodialysis Patients in Ontario

Session Information

• Dialysis: Cost, Socioeconomics, Quality of Life
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Glazer, Alysha, Ontario Renal Network, Toronto, Ontario, Canada

Alysha Glazer,

• Mackinnon, Marnie, Ontario Renal Network, Toronto, Ontario, Canada

Marnie Mackinnon,

• Heale, Esti, Ontario Renal Network, Toronto, Ontario, Canada

Esti Heale,

• Moolji, Carey, Ontario Renal Network, Toronto, Ontario, Canada

Carey Moolji,

• Ip, Jane, Cancer Care Ontario, Toronto, Ontario, Canada

Jane Ip,

• Na, Yingbo, Cancer Care Ontario, Toronto, Ontario, Canada

Yingbo Na,

• Xu, Yanqing, Bristol-Myers Squibb, Lawrenceville, New Jersey, United States

Yanqing Xu,

• Blake, Peter G., London Health Sciences Centre, London, Ontario, Canada

Peter G. Blake,

• Walsh, Michael, McMaster University, Hamilton, Ontario, Canada

Michael Walsh,

Background

People requiring dialysis reportedly experience a high symptom burden. However, there are few large studies assessing symptoms of this patient population over time. The Ontario Renal Network (ORN) is pilot testing a standardized provincial approach to symptom screening, assessment, and management using the Edmonton Symptom Assessment System Revised: Renal (ESAS-r:Renal).

Methods

Eight Regional Renal Programs in Ontario were selected to participate in a one year pilot project. Participating programs routinely assess patients undergoing in-facility hemodialysis with ESAS-r:Renal every 4 to 6 weeks. The ESAS-r:Renal questionnaire asks patients to self-report the severity of 12 symptoms between 0 (no symptom) and 10 (worst possible symptom).

Results

Between April 1 and December 31, 2017, there were 5,839 screening attempts by 1,267 patients with 90% of the questionnaires fully completed and 5% partially completed. Forty-two percent of patients were female, 48% had diabetes (Type 1 or 2), and 32% were on dialysis for 5 or more years.
Patients frequently reported changes in symptom scores over time. Tiredness was the most common symptom reported (76% of all surveys) and nausea the least reported (26% of all surveys). Scores of 7 or greater were recorded frequently (pain [14%], tiredness [22%], drowsiness [12%], nausea [3%], poor appetite [7%], shortness of breath [6%], depression [7%], anxiety [6%], poor wellbeing [11%], itching [12%], problems sleeping [17%], and restless legs [13%]).

Conclusion

Patients receiving in-facility dialysis frequently have symptoms. The degree to which the symptoms reported through ESAS-r:Renal can be modified and improved requires further research.

Funding

• Government Support - Non-U.S.