Dialysis vintage is associated with a high prevalence and severity of unpleasant symptoms in patients on hemodialysis

Abstract

Background

The burden of physical and emotional symptoms caused by somatic illness is present in most dialysis patients. However, it’s unclear how symptom burden varies among patients with different dialysis vintages. We sought to examine differences in the prevalence and severity of unpleasant symptoms in hemodialysis patients with diverse dialysis vintage cohorts.

Methods

This cross-sectional study included patients on maintenance hemodialysis at the Second Hospital of Anhui Medical University. We used the Dialysis Symptom Index (DSI) to determine the associated unpleasant symptoms, which is a validated survey to assess symptom burden/severity (higher scores indicate more severe symptoms), over June 2022 – September 2022.

Results

We studied 146 patients: 35 (24%) had a dialysis vintage of ≤12 months (group 1) and 111 (76%) had a dialysis vintage of >12 months (group 2). Concerning Group 1 patients, the prevalence and severity of unpleasant symptoms were significantly higher in Group 2, the most common individual symptoms included feeling tired or lack of energy and trouble falling asleep (i.e., 75–85% of patients in each group), with dialysis vintage being an independent influencing factor (adjusted OR, 0.19; 95% CI, 0.16 to 0.23). Lower hemoglobin levels, iron stores, and dialysis adequacy levels are correlated with longer dialysis vintage.

Conclusion

We observed a high prevalence of unpleasant symptoms and symptom clusters in a diverse dialysis vintages hemodialysis cohort. Further studies are needed to accurately and routinely define the symptom burden of chronic patients with chronic kidney disease (CKD).

Keywords:

• Hemodialysis
• dialysis intage
• unpleasant symptoms
• chronic kidney disease
• clinical characteristics

Ethical standards

Participants provide informed consent, and this study was reviewed and approved by the establishment and application of a multi-center prospective cohort of maintenance hemodialysis patients approval no. PJ-YX2020-006.

Authors’ contributions

The authors confirm the contribution to the paper as follows: study conception and design: Li Zhu, Xun Liang Li; Analysis of data: Li Zhu; Interpretation of results: Li Zhu, Xun Liang Li, Rui Si, De Guang Wang; Draft manuscript preparation: Li Zhu and Xun Liang Li. All authors have reviewed the results and approved the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statment

The data that support the findings of this study are not publicly available due to containing information that could compromise the privacy of research participants. Further inquiries can be directed to the corresponding author.

Additional information

Funding

This work was supported by research grants from the Natural Science Foundation of Anhui Province, 2008085MH244 (De-Guang Wang), Incubation Program of National Natural Science Foundation of China of The Second Hospital of Anhui Medical University, 2020GMFY04 (De-Guang Wang), Clinical Research Incubation Program of The Second Hospital of Anhui Medical University, 2020LCZD01 (De-Guang Wang). The funders of this study did notplay any role in the study design, collection, analysis, and interpretation of data, writing of thereport, or decision to submit the report for publication.