BACKGROUND: As kidney disease progresses, patients often experience a variety of symptoms. There are very few studies reporting spectrum of predialysis patients' symptoms in peritoneal dialysis (PD) patients. Furthermore, the clinical significance of predialysis patients' symptoms for PD patients' prognosis remains unknown. METHODS: In this retrospective cohort study, patients who started PD during 1 January 2006 to 31 January 2018 were included. Patients' predialysis symptoms and clinical parameters were obtained. Both the short- and long-term patients' outcome were investigated by Cox regression and Kaplan-Meier's survival analysis to identify the relationship between clinical symptoms and patients' mortality on PD. RESULTS: A total of 898 incident PD patients were included. The anorexia (58%) was the most common predialysis symptom in the present cohort, followed by insomnia (32.7%), fatigue (27.6%), syndromes of heart failure (27.6%), and nausea (20.5%). The only symptom significantly associated with both six-months and 12-months mortality on PD was nausea (HR 2.359, 95% CI 1.377-4.040, p=.002 and HR 1.791, 95% CI 1.176-2.729, p=.007, respectively). But in the long-term, anorexia (HR 1.392, 95% CI 1.070-1.811, p=.014) was the only symptom significantly associated with patient's all-cause mortality after adjusting for other confounding factors. CONCLUSIONS: Our study demonstrated that nausea and anorexia were the most important predialysis symptoms, which was associated with patients' short- and long-term mortality on PD treatment, respectively. The results indicated that predialysis evaluation and management of symptoms of nausea and anorexia may be a possible way to improve patients' outcome on PD.
BACKGROUND: As kidney disease progresses, patients often experience a variety of symptoms. There are very few studies reporting spectrum of predialysis patients' symptoms in peritoneal dialysis (PD) patients. Furthermore, the clinical significance of predialysis patients' symptoms for PDpatients' prognosis remains unknown. METHODS: In this retrospective cohort study, patients who started PD during 1 January 2006 to 31 January 2018 were included. Patients' predialysis symptoms and clinical parameters were obtained. Both the short- and long-term patients' outcome were investigated by Cox regression and Kaplan-Meier's survival analysis to identify the relationship between clinical symptoms and patients' mortality on PD. RESULTS: A total of 898 incident PDpatients were included. The anorexia (58%) was the most common predialysis symptom in the present cohort, followed by insomnia (32.7%), fatigue (27.6%), syndromes of heart failure (27.6%), and nausea (20.5%). The only symptom significantly associated with both six-months and 12-months mortality on PD was nausea (HR 2.359, 95% CI 1.377-4.040, p=.002 and HR 1.791, 95% CI 1.176-2.729, p=.007, respectively). But in the long-term, anorexia (HR 1.392, 95% CI 1.070-1.811, p=.014) was the only symptom significantly associated with patient's all-cause mortality after adjusting for other confounding factors. CONCLUSIONS: Our study demonstrated that nausea and anorexia were the most important predialysis symptoms, which was associated with patients' short- and long-term mortality on PD treatment, respectively. The results indicated that predialysis evaluation and management of symptoms of nausea and anorexia may be a possible way to improve patients' outcome on PD.
Authors: Antonio Alberto Lopes; Stacey J Elder; Nancy Ginsberg; Vittorio E Andreucci; José Miguel Cruz; Shunichi Fukuhara; Donna L Mapes; Akira Saito; Ronald L Pisoni; Rajiv Saran; Friedrich K Port Journal: Nephrol Dial Transplant Date: 2007-09-24 Impact factor: 5.992
Authors: Renée de Mutsert; Diana C Grootendorst; Jonas Axelsson; Elisabeth W Boeschoten; Raymond T Krediet; Friedo W Dekker Journal: Nephrol Dial Transplant Date: 2008-04-09 Impact factor: 5.992
Authors: Andrew S Levey; Lesley A Stevens; Christopher H Schmid; Yaping Lucy Zhang; Alejandro F Castro; Harold I Feldman; John W Kusek; Paul Eggers; Frederick Van Lente; Tom Greene; Josef Coresh Journal: Ann Intern Med Date: 2009-05-05 Impact factor: 25.391
Authors: Joanne Reid; Helen R Noble; Gary Adamson; Andrew Davenport; Ken Farrington; Denis Fouque; Kamyar Kalantar-Zadeh; John Mallett; C McKeaveney; S Porter; David S Seres; Joanne Shields; Adrian Slee; Miles D Witham; Alexander P Maxwell Journal: BMC Nephrol Date: 2018-02-13 Impact factor: 2.388