Disparities in symptom burden and renal transplant eligibility: a pilot study. Academic Article Article uri icon

Overview

MeSH

  • Aged
  • Comorbidity
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • New York City
  • Palliative Care
  • Pilot Projects
  • Quality of Life

MeSH Major

  • Kidney Transplantation
  • Patient Selection
  • Renal Dialysis
  • Severity of Illness Index

abstract

  • Patients with end-stage renal disease (ESRD) on hemodialysis (HD) suffer from a high symptom burden. However, there is significant heterogeneity within the HD population; certain subgroups, such as the elderly, may experience disproportionate symptom burden. The study's objective was to propose a category of HD patients at elevated risk for symptom burden (those patients who are not transplant candidates) and to compare symptomatology among transplant ineligible versus eligible HD patients. This was a cross-sectional study. English-speaking, cognitively intact patients receiving HD and who were either transplant eligible (n=25) or ineligible (n=32) were recruited from two urban HD units serving patients in the greater New York City region. In-person interviews were conducted to ascertain participants' symptom burden using the Dialysis Symptom Index (DSI), perceived symptom bother and attribution (whether the symptom was perceived to be related to HD treatment), and quality of life using the SF-36. Participants' medical records were reviewed to collect demographic and clinical data. Transplant ineligible (versus eligible) patients reported an average of 13.9±4.6 symptoms versus 9.2±4.4 symptoms (p<0.01); these differences persisted after adjustment for multiple factors. A greater proportion of transplant ineligible (versus eligible) patients attributed their symptoms to HD and were more likely to report greater bother on account of the symptoms. Quality of life was also significantly lower in the transplant ineligible group. Among HD patients, transplant eligibility is associated with symptom burden. Our pilot data suggest that consideration be given to employing transplant status as a method of identifying HD patients at risk for greater symptom burden and targeting them for palliative interventions.

publication date

  • November 2013

has subject area

  • Aged
  • Comorbidity
  • Female
  • Humans
  • Interviews as Topic
  • Kidney Transplantation
  • Male
  • New York City
  • Palliative Care
  • Patient Selection
  • Pilot Projects
  • Quality of Life
  • Renal Dialysis
  • Severity of Illness Index

Research

keywords

  • Journal Article
  • Multicenter Study

Identity

Language

  • eng

PubMed Central ID

  • PMC3822373

Digital Object Identifier (DOI)

  • 10.1089/jpm.2013.0026

PubMed ID

  • 24111782

Additional Document Info

start page

  • 1459

end page

  • 1465

volume

  • 16

number

  • 11