preprints.org > medicine and pharmacology > urology and nephrology > doi: 10.20944/preprints202408.1959.v1

Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Version 1 : Received: 27 August 2024 / Approved: 27 August 2024 / Online: 27 August 2024 (16:31:18 CEST)

Aim. The aim of this study is to compare data from two cohorts separated by a 17-year interval. We assessed the prevalence and severity of symptoms with the “dialysis symptom index” in these two groups recruited in 2007 and 2024 to determine how advancements in dialysis therapy have influenced symptom burden’s prevalence and severityMethods. We conducted a cross-sectional study of patients receiving thrice weekly, in-center hemodialysis. The population, recruited between February and March 2007, was comprised of patients receiving maintenance hemodialysis at the outpatient dialysis unit of our hospital. This dialysis facility is staffed by academic nephrologists. In May 2024, in the same unit, another population sample was recruited and studied as in 2007. Study coordinators administered the Dialysis Symptom Index (DSI) during the dialysis treatment. The DSI is made up of 30 questions, each of which addresses a specific physical or emotional symptom. Patients were asked to report symptoms that had been present at any time during the previous week by responding “yes” or “no”. For symptoms that were present, the patient was then asked to describe the symptom severity on a five-point Likert scale (1= not bothersome to 5=bothers very much). We generated a total symptom burden score that represents the total number of symptoms reported as being present, as well as a total symptom severity score that represents the sum of individual severity scores assigning a severity score of zero for symptoms that were not present. Results. We studied 71 patients in 2007 and 61 patients in 2024. The demographic, clinical and laboratory characteristics of the two study populations did not differ significantly. The total symptom burden score did not differ significantly between 2007 and 2024. The prevalence of most symptoms was similar in the two groups. The prevalence of constipation, decreased interest in sex and difficulty becoming sex aroused was higher in 2024 than in 2007. The total symptom severity was similar in the two periods. The severity of most symptoms was similar in the two groups. The severity of decreased interest in sex and difficulty becoming sex aroused was higher in 2024 than in 2007. Conclusion. The present study shows that, 17 years apart, the prevalence and severity of the symptom burden in patients on maintenance hemodialysis has not changed significantly. These results suggest that effort should be made to design adequate studies on the causes and pathogenesis of physical and emotional symptoms of patients on chronic hemodialysis and, once the underlying mechanisms are identified, it is amenable that high-quality studies on possible therapeutic pharmacological and non-pharmacological interventions will be performed.

hemodialysis; symptom; symptom burden; prevalence; severity

Medicine and Pharmacology, Urology and Nephrology

* All users must log in before leaving a comment