Trajectories of Uremic Symptom Severity and Kidney Function in Patients with Chronic Kidney Disease

• DOI: 10.2215/cjn.13010921
• Publication Date: 2022-03-04T19:45:13Z
• Authors: Kendra E. Wulczyn; Sophia H. Zhao; Eugene P. Rhee; Sahir Kalim; Tariq Shafi
• Keywords: Interquartile range

Background and objectives Uremic symptoms, including fatigue, anorexia, pruritus, nausea, paresthesia, pain, are attributed to the accumulation of organic waste products normally cleared by kidneys, but whether kidney function is primary driver changes in symptom severity over time not known. The goal our study was evaluate association between eGFR uremic score patients with CKD. Design, setting, participants, measurements We identified 3685 participants CKD on dialysis prospective, observational Chronic Renal Insufficiency Cohort (CRIC) Study baseline assessment severity. Symptoms were assessed separate questions Kidney Disease Quality Life-36 instrument (zero- 100-point scale). longitudinal examined multivariable adjusted linear mixed-effects models random intercepts slopes. Results mean±SD at 44±15 ml/min per 1.73 m 2 , had a median six (interquartile range 3–11) simultaneous assessments symptoms duration follow-up. most prevalent pain (57%), fatigue (52%), paresthesia (45%), pruritus (42%). In models, decrease 5 associated worsening two points or less for each ( P <0.01; zero- nonlinear. When starting from lower initial eGFR, greater magnitude worsening. Conclusions prevalence high, significant variability patient change time. Declines severity, these small uncertain clinical significance.