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Symptom-burden in people living with frailty and chronic kidney disease

Nixon, A. C.; Wilkinson, T. J.; Young, H. M. L.; Taal, M. W.; Pendleton, N.; Mitra, S.; Brady, M. E.; Dhaygude, A. P.; Smith, A. C.

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Authors

A. C. Nixon

T. J. Wilkinson

H. M. L. Young

N. Pendleton

S. Mitra

M. E. Brady

A. P. Dhaygude

A. C. Smith



Abstract

Background: Frailty is independently associated with worse health-related quality of life (HRQOL) in chronic kidney disease (CKD). However, the relationship between frailty and symptom experience is not well described in people living with CKD. This study’s aim was to evaluate the relationship between frailty and symptom-burden in CKD.

Methods: This study is a secondary analysis of a cross-sectional observational study, the QCKD study (ISRCTN87066351), in which participants completed physical activity, cardiopulmonary fitness, symptom-burden and HRQOL questionnaires. A modified version of the Frailty Phenotype, comprising 3 self-report components, was created to assess frailty status. Multiple linear regression was performed to assess the association between symptom-burden/HRQOL and frailty. Logistic regression was performed to assess the association between experiencing symptoms frequently and frailty. Principal Component Analysis was used to assess the experienced symptom clusters.

Results: A total of 353 patients with CKD were recruited with 225 (64%) participants categorised as frail. Frail participants reported more symptoms, had higher symptom scores and worse HRQOL scores. Frailty was independently associated with higher total symptom score and lower HRQOL scores. Frailty was also independently associated with higher odds of frequently experiencing 9 out of 12 reported symptoms. Finally, frail participants
experienced an additional symptom cluster that included loss of appetite, tiredness, feeling cold and poor concentration.

Conclusions: Frailty is independently associated with high symptom-burden and poor HRQOL in CKD. Moreover, people living with frailty and CKD have a distinctive symptom experience. Proactive interventions are needed that can effectively identify and address problematic symptoms to mitigate their impact on HRQOL.

Citation

Nixon, A. C., Wilkinson, T. J., Young, H. M. L., Taal, M. W., Pendleton, N., Mitra, S., …Smith, A. C. (2020). Symptom-burden in people living with frailty and chronic kidney disease. BMC Nephrology, 21, Article 411. https://doi.org/10.1186/s12882-020-02063-6

Journal Article Type Article
Acceptance Date Sep 9, 2020
Online Publication Date Sep 23, 2020
Publication Date Sep 23, 2020
Deposit Date Sep 11, 2020
Publicly Available Date Sep 23, 2020
Journal BMC Nephrology
Electronic ISSN 1471-2369
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 21
Article Number 411
DOI https://doi.org/10.1186/s12882-020-02063-6
Keywords Chronic Kidney Disease; Elderly; Quality of Life; Frailty; Geriatric Nephrology
Public URL https://nottingham-repository.worktribe.com/output/4896089
Publisher URL https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-020-02063-6

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