Symptom burden in chronic kidney disease: a review of recent literature

Background: People living with chronic kidney disease (CKD) experience multiple symptoms due to both the disease and its treatment. However, these symptoms are often underrecognised. In addition, the majority of studies have focused on an individual symptom; however, these symptoms rarely occur in isolation and may instead occur in clusters.

Aim of review: To investigate the total symptom burden in advanced CKD (Stages 4 and 5) and to identify the key instruments that are used to assess multiple symptoms.

Methods: A literature search from 2006 to 2012 was undertaken and a total of 19 articles were included.

Results: The most common CKD symptoms were fatigue or lack of energy, feeling drowsy, pain and pruritus. However, symptom assessment instruments varied between studies, often with inconsistent or inadequate symptom dimensions.

Conclusion: People with CKD experience a high symptom burden, although little is known about the burden for people with CKD Stage 4 and for those with CKD Stage 5 receiving peritoneal dialysis. This review recommends that a full range of symptoms be assessed for those at different stages of CKD. Improved understanding of the burden of symptoms can be used as the basis for treatment choices and for identifying priorities which are likely to contribute to a better quality of life and improve the quality of care.