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Kidney Week

Abstract: PO0828

Symptom Clusters in a Diverse Prospective Hemodialysis Cohort

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • You, Amy Seung, University of California Irvine, Irvine, California, United States
  • Kalantar, Sara S., University of California Berkeley, Berkeley, California, United States
  • Norris, Keith C., University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, United States
  • Amel Peralta, Rene, University of California Irvine, Irvine, California, United States
  • Narasaki, Yoko, University of California Irvine, Irvine, California, United States
  • Fischman, Ronald A., Southland Renal Medical Group, Long Beach, California, United States
  • Fischman, Michael Alan, Southland Renal Medical Group, Long Beach, California, United States
  • Semerjian, Avedik, Southland Renal Medical Group, Long Beach, California, United States
  • Azadbadi, Zahra, University of California Irvine, Irvine, California, United States
  • Nguyen, Danh V., University of California Irvine, Irvine, California, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine, Irvine, California, United States
  • Rhee, Connie, University of California Irvine, Irvine, California, United States
Background

Hemodialysis (HD) patients experience a high symptom burden similar to that of patients with malignancy, which may adversely impact their quality of life and well-being. Given that emerging data in other fields (oncology) show that symptoms often occur in clusters, we examined the presence of symptom clusters in a diverse prospective HD cohort.

Methods

In 122 HD patients from the prospective Malnutrition, Diet, and Racial Disparities in Chronic Kidney Disease study recruited across 16 outpatient dialysis clinics, the presence of CKD-associated symptoms was ascertained by the Dialysis Symptom Index (DSI), a 30-item validated survey that assesses symptom severity (score range 0-120, higher scores indicating greater severity), over 7/2020-8/2020. Using the DSI surveys, we examined the presence of symptom clusters (≥2 symptoms related to each other and occurring together) across domains categorized by organ system.

Results

The mean±SD age of the cohort was 60±13 yrs, among whom 51% were female, 22% were Black, and 62% were Hispanic. Across the 30-item DSI survey, the most common individual symptoms included feeling tired/lack of energy (71%), dry skin (61%), itching (42%), muscle cramps (42%), and numbness/tingling in feet (41%). Upon examining co-existing symptoms, there was a high prevalence of symptom clusters, with the most common pairings including: 1) having trouble falling asleep + feeling tired/lack of energy or trouble staying asleep, 2) having trouble staying asleep + feeling tired/lack of energy, 3) dry skin + itching, 4) dry skin + dry mouth, and 5) decreased interest in sex + difficulty becoming aroused.

Conclusion

We observed a high prevalence of symptom clusters in a well-defined, diverse prospective HD cohort. Further studies are needed to determine the physiologic underpinnings of concurrent symptoms in order to identify targeted therapies that can ameliorate the high symptom burden of HD patients.

Funding

  • NIDDK Support