Determining which symptoms have the greatest impact on quality of life in patients with non-dialysis dependent CKD

INTRODUCTION: CKD patients suffer with a high symptom burden which is inadequately measured in clinical practice. This high symptom burden is known to impact quality of life, however there is limited understanding of which symptoms most affect patients particularly in the early stages of CKD. The aim of this study was to determine which individual symptoms have the greatest impact on quality of life in patients with non-dialysis CKD.METHODS: Self-reported symptoms of 155 CKD patients [43% females, mean age, 55.0 (SD: 17.1) years, eGFR, 40.6 (SD: 26.6) ml/min/1.73m²] were assessed using the recently validated Kidney Symptom Questionnaire. The 13 symptoms were classified into binary variables (i.e. apparent: at least once per week or non-apparent). Linear regression was used to determine the association between individual symptoms and quality of life, measured using the EQ5D index values (where 1 equates to highest quality of life and -0.594 to lowest quality of life).RESULTS: In order of prevalence, the top six most common symptoms were: ‘Feeling tired’ (90%); ‘Cramp/muscle stiffness’ (78%), ‘Polynocturia’ (76%); ‘Sleep disturbance/insomnia’ (71%), ‘Feeling cold’ (66%) and ‘Bone/joint pain’ (65%). The mean total symptom score was 22.7 (SD: 12.9) out of a possible 52. The mean EQ5D index was 0.70 (SD: 0.27).Increasing symptom burden was significantly correlated with a lower quality of life (r=-0.617, p