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Symptom burden and quality of life in end-stage renal disease: a study of 179 patients on dialysis and palliative care

Department of Medicine & Geriatrics, Caritas Medical Centre, Kowloon

AOL Kwok

Department of Medicine & Geriatrics, Caritas Medical Centre, Kowloon

DML Wong

Department of Medicine & Geriatrics, Caritas Medical Centre, Kowloon

MHP Suen

Medical Social Work Department, Caritas Medical Centre, Kowloon

WT Chen

Department of Medicine & Geriatrics, Caritas Medical Centre, Kowloon

DMW Tse

Department of Medicine & Geriatrics, Caritas Medical Centre, Kowloon mwtse{at}ha.org.hk

Palliative care for end-stage renal disease (ESRD) is developing in Hong Kong. This is the first local study to explore the symptom burden and quality of life (QOL) of ESRD patients on chronic dialysis and palliative care. This was a prospective cross-sectional study conducted on ESRD patients in a hospital in Hong Kong from January 2006 to April 2007. Data collected included demographics, socioeconomic status, modified Charlson Comorbidity Index (CCI), prevalence and intensity of 23 ESRD-related symptoms as rated by numerical rating scale (0–10), Brief Pain Inventory and QOL by MOS SF-36. A total of 179 ESRD patients completed the study; 45 patients (25.1%) were in the palliative care group and 134 patients (74.9%) in the dialysis group. The palliative care group were older (73.1 ± 7.1 vs 58.2 ± 11.4 years, P < 0.001), had marginally higher modified CCI (8.5 ± 1.9 vs 6.1 ± 2.4, P = 0.05), had more diabetics (62.2 vs 35.8%, P < 0.001) and were of poorer socioeconomic status than the dialysis group. The mean number of symptoms was 8.2 ± 3.9 and 9.3 ± 4.7 in the palliative care and the dialysis group, respectively (P = NS). Fatigue, cold aversion, pruritus, lower torso weakness and difficulty sleeping were the five most prevalent symptoms in both groups, and were also among the most intense symptoms. QOL was significantly impaired in both groups. Scores of all QOL domains correlated negatively with the number of symptoms (P < 0.001). Our ESRD patients under palliative care and dialysis had overlapping symptom prevalence and intensity, significant symptom burden and impaired QOL.

Key Words: dialysis • end-stage renal disease • Hong Kong • palliative care • QOL • symptom burden

This version was published on March 1, 2009

Palliative Medicine, Vol. 23, No. 2, 111-119 (2009)
DOI: 10.1177/0269216308101099


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