Symptom Burden and Its Impact on Quality of Life in Patients With Moderate to Severe CKD: The International Chronic Kidney Disease Outcomes and Practice Patterns Study (CKDopps) - Archive ouverte HAL
Article Dans Une Revue American Journal of Kidney Diseases Année : 2024

Symptom Burden and Its Impact on Quality of Life in Patients With Moderate to Severe CKD: The International Chronic Kidney Disease Outcomes and Practice Patterns Study (CKDopps)

Ricardo Sesso
  • Fonction : Auteur
Antonio A. Lopes
  • Fonction : Auteur
Roberto Pecoits-Filho
  • Fonction : Auteur
Fredric O. Finkelstein
  • Fonction : Auteur
Charlotte Tu
  • Fonction : Auteur
Ronald L. Pisoni
  • Fonction : Auteur
Jarcy Zee
  • Fonction : Auteur
Antonio Lopes
  • Fonction : Auteur
Christian Combe
  • Fonction : Auteur
Christian Jacquelinet
  • Fonction : Auteur
Ziad Massy
  • Fonction : Auteur
Benedicte Stengel
  • Fonction : Auteur
Johannes Duttlinger
  • Fonction : Auteur
Danilo Fliser
  • Fonction : Auteur
Gerhard Lonnemann
  • Fonction : Auteur
Helmut Reichel
  • Fonction : Auteur
Takashi Wada
  • Fonction : Auteur
Kunihiro Yamagata
  • Fonction : Auteur
Ron Pisoni
  • Fonction : Auteur
Bruce Robinson
  • Fonction : Auteur
Viviane Calice da Silva
  • Fonction : Auteur
Koichi Asahi
  • Fonction : Auteur
Junichi Hoshino
  • Fonction : Auteur
Ichiei Narita
  • Fonction : Auteur
Rachel Perlman
  • Fonction : Auteur
Friedrich Port
  • Fonction : Auteur
Nidhi Sukul
  • Fonction : Auteur
Michelle Wong
  • Fonction : Auteur
Eric Young
  • Fonction : Auteur

Résumé

© 2024 National Kidney Foundation, Inc.Rationale & Objective: Recent evidence suggests people with nondialysis chronic kidney disease (ND-CKD) experience a substantial burden of symptoms, but informative large-scale studies have been scarce. We assessed the prevalence of symptoms and the association of overall symptom burden with quality of life in patients with moderate to severe CKD. Study Design: Cross-sectional study. Setting & Participants: 4,430 patients with ND-CKD stages 3-5 enrolled in the Chronic Kidney Disease Outcomes and Practice Patterns Study (CKDopps) in Brazil, France, and the United States between 2013 and 2021. Exposure: 13 individual patient-reported symptoms from the Kidney Disease Quality of Life Short Form (KDQOL-SF) questionnaire and an overall symptom burden score (low, intermediate, and high). Outcome: Physical and mental component summary scores (PCS and MCS) of the KDQOL-SF. Analytical Approach: Adjusted prevalence ratios and generalized estimating equations. Results: Patients (mean age, 68 years; 40% women; mean baseline estimated glomerular filtration rate [eGFR], 30 mL/min/1.73 m2) were very much to extremely bothered by numerous symptoms (u201csoreness in muscles,u201d 23%; u201cwashed out or drained,u201d 21%; u201ccramps, shortness of breath, dry skin, diminished sex life, or numbness in hands or feet,u201d 14%-17%). The adjusted prevalences of u201ccramps,u201d u201cwashed out or drained,u201d u201clack of appetite,u201d u201cnausea/upset stomach,u201d and u201csex lifeu201d were greater with more severe CKD and in women (except for u201csex lifeu201d). A high overall symptom burden was more common in women, in France, and in patients with severe albuminuria and various comorbidities, but not with lower eGFR. The PCS and MCS scores were 13.4 and 7.7 points lower, respectively, for high versus low overall symptom burden. Limitations: Generalizability limited to patients under nephrology care, residual confounding, and inaccurate Brazilian translation of some symptoms. Conclusions: The high symptom burden observed in this large cohort of ND-CKD patients across 3 diverse countries and its strong association with poorer health-related quality of life should inform clinical management of and clinical research in CKD. Plain-Language Summary: Little is known about symptoms in patients with non-dialysis-dependent chronic kidney disease (ND-CKD). In the Chronic Kidney Disease Outcomes and Practice Patterns Study, which enrolled 4,430 patients with CKD stages 3-5 in Brazil, France, and the United States, patients most often reported soreness in muscles, feeling washed out or drained, cramps, shortness of breath, dry skin, altered sex life, and numbness in hands or feet. Cramps, feeling washed out or drained, lack of appetite, and nausea were more often reported at lower levels of kidney function. The overall symptom burden was higher in women than men, in French than in Brazilian or US patients, and in those with severe albuminuria. The higher the symptom burden, the lower were the physical and mental health quality of life scores. The high symptom burden observed in this large cohort of ND-CKD patients across 3 diverse countries and its strong association with poorer health-related quality of life should inform clinical management of and clinical research in CKD.
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Dates et versions

hal-04771021 , version 1 (07-11-2024)

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Elodie Speyer, Emilie Moutard, Bénédicte Stengel, Natalia Alencar de Pinho, Abdou Y. Omorou, et al.. Symptom Burden and Its Impact on Quality of Life in Patients With Moderate to Severe CKD: The International Chronic Kidney Disease Outcomes and Practice Patterns Study (CKDopps). American Journal of Kidney Diseases, 2024, ⟨10.1053/j.ajkd.2024.06.011⟩. ⟨hal-04771021⟩
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