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Five-Year Symptom Trajectories in Nondialysis-Dependent CKD Patients.

Moustapha Faye Karine Legrand 1, 2 Lisa Le Gall 3 Karen Leffondre 4 Abdou Y. Omorou 5, 6 Natalia Alencar De Pinho Christian Combe 7, 8 Denis Fouque 9 Christian Jacquelinet 10 Maurice Laville 9 Sophie Liabeuf 11 Ziad A. Massy 12, 13 Elodie Speyer 13 Roberto Pecoits Filho Bénédicte Stengel 14, 13, 15, 16 Luc Frimat 17 Carole Ayav 18 
Abstract : BACKGROUND AND OBJECTIVES: Late stages of CKD are characterized by significant symptom burden. This study aimed to identify subgroups within the 5-year trajectories of symptom evolution in patients with CKD and to describe associated patient characteristics and outcomes. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Among 2787 participants (66% men) with eGFR <60 ml/min per 1.73 m(2) enrolled in the CKD-Renal Epidemiology and Information Network (CKD-REIN) cohort study from July 2013 to May 2016, we assessed symptoms annually using the Kidney Disease Quality of Life-36 (KDQOL-36) questionnaire until December 2020. A total of 9121 measures were reported over follow-up; all participants had symptoms scored for at least one time point. We used a joint latent class-mixed model to distinguish profiles of symptom trajectories. RESULTS: Patient mean age (±SD) at baseline was 67±13 years, and mean eGFR was 33±13 ml/min per 1.73 m(2). The prevalence of each symptom ranged from 24% (chest pain) to 83% (fatigue), and 98% of participants reported at least one symptom. After a median (interquartile range) follow-up of 5.3 (3.4-6.0) years, 690 participants initiated KRT, and 490 died before KRT. We identified two profiles of symptom trajectories: a "worse symptom score and worsening trajectory" in 31% of participants, characterized by a low initial symptom score that worsened more than ten points over time, and a "better symptom score and stable trajectory" in 69% of participants, characterized by a high initial score that remained stable. Participants in the worse symptom score and worsening trajectory group had more risk factors for CKD progression at baseline, worse quality of life, and a higher risk of KRT and death before KRT than other participants. CONCLUSIONS: This study highlights a significant worsening of symptoms in about one third of the participants, whereas the majority reported low symptom severity throughout the study.
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Soumis le : jeudi 3 novembre 2022 - 15:07:55
Dernière modification le : samedi 5 novembre 2022 - 03:29:35



Moustapha Faye, Karine Legrand, Lisa Le Gall, Karen Leffondre, Abdou Y. Omorou, et al.. Five-Year Symptom Trajectories in Nondialysis-Dependent CKD Patients.. Clinical Journal of the American Society of Nephrology, 2022, pp.CJN.06140522. ⟨10.2215/CJN.06140522⟩. ⟨hal-03838383⟩



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