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Enfermería Nefrológica

On-line version ISSN 2255-3517Print version ISSN 2254-2884


GUTIERREZ SANCHEZ, Daniel; LEIVA-SANTOS, Juan P.; MACIAS LOPEZ, María José  and  CUESTA VARGAS, Antonio I.. Symptomatic profile of patients with Chronic Kidney Disease Stage 4 and 5. Enferm Nefrol [online]. 2017, vol.20, n.3, pp.259-266. ISSN 2255-3517.


Patients with Advanced Chronic Kidney Disease (ACKD) experience multiple symptoms that negatively affect the quality of life.


To determine the prevalence and severity of symptoms, and their association with the glomerular filtration rate (GFR) and comorbidities.

Material and method:

A cross-sectional study to examine the prevalence of symptoms in patients with ACKD on dialysis and predialysis, and their association with GFR and comorbidities was carried out. Symptom data were collected using the Spanish modified version of Palliative care Outcome Scale- Symptoms Renal (POS-S Renal), a validated questionnaire to assess symptoms in this population. Comorbidity was collected and scored according to the modified Charlson Comorbidity Index (mCCI).


The study sample included 180 patients with ACKD. More than 44% of patients described weakness, pain, depression and difficulty sleeping. There was a significant difference in the prevalence of symptoms between groups for weakness (p=0.027), poor mobility (p=0.018), drowsiness (p=0.03), constipation (p=0.015) and restless legs (p<0.01). There was no association between disease severity and symptoms (p=0,04). There was no significant correlation between comorbidities and symptoms (p=0,15).


Patients with ACKD experience a high level of symptom burden. Routine symptom assessment using tools such as the POS-S Renal can be useful in clinical and research settings. Integrating the principles of Palliative Care in Nephrology Services can be beneficial for optimizing the symptom management in this population.

Keywords : advanced chronic kidney disease; symptoms assessment; questionnaires.

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