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Nephrol Dial Transplant. 2018 Jun 13. doi: 10.1093/ndt/gfy155. [Epub ahead of print]

Uraemic symptom burden and clinical condition in women and men of ≥65 years of age with advanced chronic kidney disease: results from the EQUAL study.

Collaborators (229)

Adamasco Cupisti IT, Adelia Sagliocca IT, Alberto Ferraro IT, Aleksandra Musiała PL, Alessandra Mele IT, Alessandro Naticchia IT, Alex Còsaro IT, Alistair Woodman UK, Andrea Ranghino IT, Andrea Stucchi IT, Andreas Jonsson SE, Andreas Schneider DE, Angelo Pignataro IT, Anita Schrander NL, Anke Torp DE, Anna McKeever UK, Anna Szymczak PL, Anna-Lena Blom SE, Antonella De Blasio IT, Antonello Pani IT, Aris Tsalouichos IT, Asad Ullah UK, Barbara McLaren UK, Bastiaan van Dam NL, Beate Iwig DE, Bellasi Antonio IT, Biagio Raffaele Di Iorio IT, Björn Rogland SE, Boris Perras DE, Butti Alessandra IT, Camille Harron UK, Carin Wallquist SE, Carl Siegert NL, Carla Barrett UK, Carlo Gaillard NL, Cataldo Abaterusso IT, Charles Beerenhout NL, Charlotte O'Toole UK, Chiara Somma IT, Christian Marx DE, Christina Summersgill UK, Christof Blaser DE, Claudia D'alessandro IT, Claudia Emde DE, Claudia Zullo IT, Claudio Pozzi IT, Colin Geddes UK, Cornelis Verburgh NL, Daniela Bergamo IT, Daniele Ciurlino IT, Daria Motta IT, Deborah Glowski UK, Deborah McGlynn UK, Denes Vargas SE, Detlef Krieter DE, Domenico Russo IT, Dunja Fuchs DE, Dympna Sands UK, Ellen Hoogeveen NL, Ellen Irmler DE, Emöke Dimény SE, Enrico Favaro IT, Eva Platen DE, Ewelina Olczyk PL, Ewout Hoorn NL, Federica Vigotti IT, Ferruccio Ansali IT, Ferruccio Conte IT, Francesca Cianciotta IT, Francesca Giacchino IT, Francesco Cappellaio IT, Francesco Pizzarelli IT, Fredrik Sundelin SE, Fredrik Uhlin SE, Gaetano Greco IT, Geena Roy UK, Gaetana Porto IT, Giada Bigatti IT, Giancarlo Marinangeli IT, Gianfranca Cabiddu IT, Gillian Hirst UK, Giordano Fumagalli IT, Giorgia Caloro IT, Giorgina Piccoli IT, Giovanbattista Capasso IT, Giovanni Gambaro IT, Giuliana Tognarelli IT, Giuseppe Bonforte IT, Giuseppe Conte IT, Giuseppe Toscano IT, Goffredo Del Rosso IT, Gunilla Welander SE, Hanna Augustyniak-Bartosik PL, Hans Boots NL, Hans Schmidt-Gürtler DE, Hayley King UK, Helen McNally UK, Hendrik Schlee DE, Henk Boom NL, Holger Naujoks DE, Houda Masri-Senghor UK, Hugh Murtagh UK, Hugh Rayner UK, Ilona Miśkowiec-Wiśniewska PL, Ines Schlee DE, Irene Capizzi IT, Isabel Bascaran Hernandez SE, Ivano Baragetti IT, Jacek Manitius PL, Jane Turner UK, Jan-Willem Eijgenraam NL, Jeroen Kooman NL, Joachim Beige DE, Joanna Pondel PL, Joanne Wilcox UK, Jocelyn Berdeprado UK, Jochen Röthele DE, Jonathan Wong UK, Joris Rotmans NL, Joyce Banda UK, Justyna Mazur DE, Kai Hahn DE, Kamila Jędrzejak PL, Katarzyna Nowańska PL, Katja Blouin DE, Katrin Neumeier DE, Kirsteen Jones UK, Kirsten Anding-Rost DE, Knut-Christian Gröntoft SE, Lamberto Oldrizzi IT, Lesley Haydock UK, Liffert Vogt NL, Lily Wilkinson UK, Loreto Gesualdo IT, Lothar Schramm DE, Luigi Biancone IT, Łukasz Nowak PL, Maarten Raasveld NL, Magdalena Durlik PL, Manuela Magnano IT, Marc Vervloet NL, Marco Ricardi IT, Margaret Carmody UK, Maria Di Bari IT, Maria Laudato IT, Maria Luisa Sirico IT, Maria Stendahl SE, Maria Svensson SE, Maria Weetman UK, Marjolijn van Buren NL, Martin Joinson UK, Martina Ferraresi IT, Mary Dutton UK, Merel van Diepen NL, Michael Matthews UK, Michele Provenzano IT, Monika Hopf DE, Moreno Malaguti IT, Nadja Wuttke DE, Neal Morgan UK, Nicola Palmieri IT, Nikolaus Frischmuth DE, Nina Bleakley UK, Paola Murrone IT, Paul Cockwell UK, Paul Leurs NL, Paul Roderick UK, Pauline Voskamp NL, Pavlos Kashioulis SE, Pawlos Ichtiaris DE, Peter Blankestijn NL, Petra Kirste DE, Petra Schulz DE, Phil Mason UK, Philip Kalra UK, Pietro Cirillo IT, Pietro Dattolo IT, Pina Acampora IT, Rincy Sajith UK, Rita Nigro IT, Roberto Boero IT, Roberto Scarpioni IT, Rosa Sicoli IT, Rosella Malandra IT, Sabine Aign DE, Sabine Cäsar DE, Sadie van Esch NL, Sally Chapman UK, Sandra Biribauer DE, Santee Navjee UK, Sarah Crosbie UK, Sharon Brown UK, Sheila Tickle UK, Sherin Manan DE, Silke Röser DE, Silvana Savoldi IT, Silvio Bertoli IT, Silvio Borrelli IT, Siska Boorsma NL, Stefan Heidenreich DE, Stefan Melander SE, Stefania Maxia IT, Stefano Maffei IT, Stefano Mangano IT, Stephanie Palm DE, Stijn Konings NL, Suresh Mathavakkannan UK, Susanne Schwedler DE, Sylke Delrieux DE, Sylvia Renker DE, Sylvia Schättel DE, Szyszkowska Dorota PL, Teresa Cicchetti IT, Teresa Nieszporek PL, Theresa Stephan DE, Thomas Schmiedeke DE, Thomas Weinreich DE, Til Leimbach DE, Tiziana Rappa IT, Tora Almquist SE, Torsten Stövesand DE, Udo Bahner DE, Ulrika Jensen SE, Valentina Palazzo IT, Walter De Simone IT, Wolfgang Seeger DE, Ying Kuan UK, Zbigniew Heleniak PL, Zeynep Aydin NL.

Author information

1
ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands.
2
UK Renal Registry, Southmead Hospital, Bristol, UK.
3
Department of Medicine, Division of Nephrology, University Hospital of Würzburg, Würzburg, Germany.
4
Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, CNR-IFC, Reggio Calabria, Italy.
5
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
6
Department of Nephrology and Transplantation, Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
7
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
8
Department of Clinical Sciences Intervention and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden.

Abstract

Background:

The epidemiology and prognosis of chronic kidney disease (CKD) differ by sex. We aimed to compare symptom prevalence and the clinical state in women and men of ≥65 years of age with advanced CKD receiving routine nephrology care.

Methods:

The European QUALity study on treatment in advanced chronic kidney disease (EQUAL) study follows patients from six European countries of ≥65 years of age  years whose estimated glomerular filtration rate (eGFR) dropped to ≤20 mL/min/1.73 m2 for the first time during the last 6 months. The Dialysis Symptom Index was used to assess the prevalence and severity of 33 uraemic symptoms. Data on the clinical state at baseline were collected from medical records. Prevalence was standardized using the age distribution of women as the reference.

Results:

The results in women (n = 512) and men (n = 967) did not differ with age (77.0 versus 75.7 years) or eGFR (19.0 versus 18.5). The median number of symptoms was 14 [interquartile range (IQR) 9-19] in women, and 11 (IQR 7-16) in men. Women most frequently reported fatigue {39% [95% confidence interval (CI) 34-45]} and bone/joint pain [37% (95% CI 32-42)] as severe symptoms, whereas more men reported difficulty in becoming sexually aroused [32% (95% CI 28-35)] and a decreased interest in sex [31% (95% CI 28-35)]. Anaemia [73% (95% CI 69-77) versus 85% (95% CI 82-87)] was less common in women than in men, as were smoking history and cardiovascular comorbidity. However, a diagnosis of liver disease other than cirrhosis, psychiatric disease and mild malnutrition were more common among women.

Conclusions:

Women in secondary care with an incident eGFR ≤20 mL/min/1.73 m2 reported a higher symptom burden, while their clinical state was considered similar or even more favourable as compared with men.

PMID:
29905848
DOI:
10.1093/ndt/gfy155

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