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Value Health Reg Issues. 2019 Jan 10;20:28-35. doi: 10.1016/j.vhri.2018.10.003. [Epub ahead of print]

Prevalence of Symptoms and Symptom Clusters of Patients on Dialysis in Uruguay.

Author information

1
Medical Psychology Department, Faculty of Medicine, Universidad de la República, Uruguay.
2
Medical Psychology Department, Faculty of Medicine, Universidad de la República, Uruguay. Electronic address: jdapueto@hc.edu.uy.
3
Unit of Biometrics, Institute of Statistics, Faculty of Economics and Administration, Universidad de la República, Uruguay.
4
Departments of Nephrology and Physiopathology, Faculty of Medicine, Universidad de la República, Uruguay.

Abstract

BACKGROUND:

Patients on dialysis report high levels of symptom burden. The association of these symptoms may have an increased deleterious effect on the patients' well-being.

OBJECTIVE:

This study aimed to assess the prevalence of symptoms, to identify symptom clusters, and to describe the impact of concurrent symptoms on physical and emotional well-being in a sample of dialysis patients.

METHODS:

Data of the first assessment of a longitudinal study aimed to assess patient-reported outcomes in dialysis were included here. The KDQOL-36 PCS, MCS and Symptom Subscale, the Hospital Anxiety and Depression Scales and the Epworth Sleepiness Scale were analyzed. The ICLUST procedure was followed for hierarchical cluster analyses.

RESULTS:

Of the 512 eligible patients, 493 accepted to participate, 43.6 % were female, with mean age of 60.9 (SD=16.7). Treatment modality was HD in 87.6% of patients. Most prevalent and severe symptoms were muscle sores, cramps, "washed out", dry skin, and itchy skin, Moderate to severe pain was reported by 25%, and daily somnolence by 12.4% of the patients. Five first level symptom clusters were identified as cutaneous, cardiac, digestive, sensory-motor, energy. Both, the presence of any cluster and cluster scores were significantly associated with lower physical and mental quality of life and a higher psychological distress.

CONCLUSIONS:

Our study confirms the presence of high symptom burden in dialysis patients in Uruguay. Several symptom clusters were identified having significant impact on the patients' well-being. The identification of symptom clusters can help to understand common underlying pathways. It is possible that the management of symptom clusters may reduce symptom burden in these patients.

KEYWORDS:

Uruguay; dialysis; hierarchical cluster analysis; symptom clusters

PMID:
30639978
DOI:
10.1016/j.vhri.2018.10.003

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