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The prevalence of symptons in end-stage renal disease: a systematic review

Record type: Article

Symptoms in end-stage renal disease (ESRD) are underrecognized. Prevalence studies have focused on single symptoms rather than on the whole range of symptoms experienced. This systematic review aimed to describe prevalence of all symptoms, to better understand total symptom burden. Extensive database, “gray literature,” and hand searches were undertaken, by predefined protocol, for studies reporting symptom prevalence in ESRD populations on dialysis, discontinuing dialysis, or without dialysis. Prevalence data were extracted, study quality assessed by use of established criteria, and studies contrasted/combined to show weighted mean prevalence and range. Fifty-nine studies in dialysis patients, one in patients discontinuing dialysis, and none in patients without dialysis met the inclusion criteria. For the following symptoms, weighted mean prevalence (and range) were fatigue/tiredness 71% (12% to 97%), pruritus 55% (10% to 77%), constipation 53% (8% to 57%), anorexia 49% (25% to 61%), pain 47% (8% to 82%), sleep disturbance 44% (20% to 83%), anxiety 38% (12% to 52%), dyspnea 35% (11% to 55%), nausea 33% (15% to 48%), restless legs 30% (8%to 52%), and depression 27% (5%to 58%). Prevalence variations related to differences in symptom definition, period of prevalence, and level of severity reported. ESRD patients on dialysis experience multiple symptoms, with pain, fatigue, pruritus, and constipation in more than 1 in 2 patients. In patients discontinuing dialysis, evidence is more limited, but it suggests they too have significant symptom burden. No evidence is available on symptom prevalence in ESRD patients managed conservatively (without dialysis). The need for greater recognition of and research into symptom prevalence and causes, and interventions to alleviate them, is urgent.

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Citation

Murtagh, Fliss E.M., Addington-Hall, Julia and Higginson, Irene J. (2007) The prevalence of symptons in end-stage renal disease: a systematic review Advances in Chronic Kidney Disease, 14, (1), pp. 82-99. (doi:10.1053/j.ackd.2006.10.001).

More information

Published date: 2007
Keywords: end-stage renal disease, symptoms, symptom prevalence, systematic review, dialysis

Identifiers

Local EPrints ID: 43960
URI: http://eprints.soton.ac.uk/id/eprint/43960
ISSN: 1548-5595
PURE UUID: cb3ab3da-3564-494c-977b-bd052ba87d5f

Catalogue record

Date deposited: 19 Feb 2007
Last modified: 17 Jul 2017 15:16

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Contributors

Author: Fliss E.M. Murtagh
Author: Irene J. Higginson

University divisions


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