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Predictors of symptom burden among hemodialysis patients: a cross-sectional study at 13 hospitals

  • Nephrology - Original Paper
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Abstract

Purpose

This study investigated the clinical characteristics and symptomatology of ESRD patients in Jordan taking a multidimensional approach.

Methods

This was a cross-sectional study that included a cohort of 620 patients undergoing maintenance hemodialysis (HD). Data were retrieved via patient survey administration and electronic health records. A modified version of the Charlson Comorbidity index (CCI) was utilized to assess comorbidity. Symptoms were assessed using the validated Arabic version of the CKD Symptom Burden Index (CKD-SBI).

Results

The mean (± SD) age of participants was 50.9 ± 16.1 years, with the 59.8% being males. Diabetes was the leading cause of kidney disease among patients (29.2%), followed by hypertension (20.7%) and medication use (8.6%). Common comorbidities included hypertension (72.4%), diabetes (38.4%), and cardiovascular disease (18.7%). Patients experienced 13 CKD-related symptoms on average, with a total symptom burden score of 29.6. Muscle strain was the most common symptom (62.6%), followed by itchiness (59.7%), nervousness (57.7%), and anxiety (57.7%). Charlson comorbidity index (CCI) [β = 0.88, 95% CI (0.34–1.41)], male gender [β = − 5.59; 95% CI (− 8.34 to − 2.85)], higher educational level [β = − 3.38; 95% CI (− 6.39 to − 0.37)], and number of dialysis sessions/week (β = 6.22, 95% CI 3.37–9.07) were independent predictors of total symptom burden. Similarly, these factors predicted symptom troublesomeness, intensity, and recurrence.

Conclusion

A holistic clinical picture of ESRD that includes multidimensional symptom assessment is warranted for better disease management and resource allocation. Our paper identifies key characteristic of this population and factors contributing to total symptom burden.

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Acknowledgements

This work was supported by the Deanship of Scientific Research at Jordan University of Science and Technology (Grant number 67/2018).

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Authors and Affiliations

  1. Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, P.O. Box 566, Irbid, 21163, Jordan

    Reema Karasneh

  2. Clinical Pharmacy Department, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan

    Sayer Al-Azzam, Shoroq M. Altawalbeh, Osama Y. Alshogran & Sahar Hawamdeh

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  1. Reema Karasneh
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  2. Sayer Al-Azzam
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  3. Shoroq M. Altawalbeh
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  4. Osama Y. Alshogran
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by SAA, RK, and SA. The first draft of the manuscript was written by SH and RK, and all authors commented on the previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Reema Karasneh.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (at King Abdullah Hospital, Jordan reference number 16/112/2018) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Karasneh, R., Al-Azzam, S., Altawalbeh, S.M. et al. Predictors of symptom burden among hemodialysis patients: a cross-sectional study at 13 hospitals. Int Urol Nephrol 52, 959–967 (2020). https://doi.org/10.1007/s11255-020-02458-2

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