Symptom burden and associated factors in renal transplant patients in the U.K

Abstract

Context: Renal transplantation is gold standard care in end-stage kidney disease, but little is known about symptom prevalence in transplanted patients.

Objectives: This study assesses symptom prevalence in this population.

Methods: This was a U.K.-based, cross-sectional symptom survey of end-stage kidney disease patients transplanted more than one year previously. Patient-reported data were collected using the renal Patient Outcome Scale. Demographic/clinical data also were collected, including estimated glomerular filtration rate (eGFR), renal diagnosis, and comorbidity.

Results: One hundred ten patients participated; mean age was 47 years (SD 13.6), and mean eGFR was 46 mL/min (SD 16.8, range 14-101). Symptom burden was high, with a mean of seven symptoms, but marked variance (SD 5.2, range 0-22). The most prevalent symptoms were weakness (56%, 95% CI 47-65), difficulty sleeping (46%, 95% CI 37-56), dyspnea (42%, 95% CI 33-51), feeling anxious (36%, 95% CI 28-46), and drowsiness (36%, 95% CI 28-46). Certain symptoms-weakness, difficulty sleeping, dyspnea, and drowsiness-were commonly reported as severe. A significant inverse relationship between renal function, as measured by eGFR, and number of symptoms (P<0.05) emerged.

Conclusion: For renal transplant recipients, symptom burden is similar to dialysis, although with less pain, anorexia, and immobility. Routine symptom assessment should be undertaken in transplant patients to identify these often undisclosed symptoms.