Multicenter Study

. 2019 Jul 1;34(7):1189-1196.

doi: 10.1093/ndt/gfy155.

Uraemic symptom burden and clinical condition in women and men of ≥65 years of age with advanced chronic kidney disease: results from the EQUAL study

Moniek W M van de Luijtgaarden¹, Fergus J Caskey², Christoph Wanner³, Nicholas C Chesnaye¹, Maurizio Postorino⁴, Cynthia J Janmaat⁵, Anirudh Rao⁶, Claudia Torino⁴, Marian Klinger⁷, Christiane Drechsler³, Olof Heimburger⁸, Maciej Szymczak⁷, Marie Evans⁸, Friedo W Dekker⁵, Kitty J Jager¹; EQUAL study investigators

Collaborators, Affiliations

Collaborators

EQUAL study investigators:
I T Adamasco Cupisti, I T Adelia Sagliocca, I T Alberto Ferraro, P L Aleksandra Musiała, I T Alessandra Mele, I T Alessandro Naticchia, I T Alex Còsaro, U K Alistair Woodman, I T Andrea Ranghino, I T Andrea Stucchi, S E Andreas Jonsson, D E Andreas Schneider, I T Angelo Pignataro, N L Anita Schrander, D E Anke Torp, U K Anna McKeever, P L Anna Szymczak, S E Anna-Lena Blom, I T Antonella De Blasio, I T Antonello Pani, I T Aris Tsalouichos, U K Asad Ullah, U K Barbara McLaren, N L Bastiaan van Dam, D E Beate Iwig, I T Bellasi Antonio, I T Biagio Raffaele Di Iorio, S E Björn Rogland, D E Boris Perras, I T Butti Alessandra, U K Camille Harron, S E Carin Wallquist, N L Carl Siegert, U K Carla Barrett, N L Carlo Gaillard, I T Cataldo Abaterusso, N L Charles Beerenhout, U K Charlotte O'Toole, I T Chiara Somma, D E Christian Marx, U K Christina Summersgill, D E Christof Blaser, I T Claudia D'alessandro, D E Claudia Emde, I T Claudia Zullo, I T Claudio Pozzi, U K Colin Geddes, N L Cornelis Verburgh, I T Daniela Bergamo, I T Daniele Ciurlino, I T Daria Motta, U K Deborah Glowski, U K Deborah McGlynn, S E Denes Vargas, D E Detlef Krieter, I T Domenico Russo, D E Dunja Fuchs, U K Dympna Sands, N L Ellen Hoogeveen, D E Ellen Irmler, S E Emöke Dimény, I T Enrico Favaro, D E Eva Platen, P L Ewelina Olczyk, N L Ewout Hoorn, I T Federica Vigotti, I T Ferruccio Ansali, I T Ferruccio Conte, I T Francesca Cianciotta, I T Francesca Giacchino, I T Francesco Cappellaio, I T Francesco Pizzarelli, S E Fredrik Sundelin, S E Fredrik Uhlin, I T Gaetano Greco, U K Geena Roy, I T Gaetana Porto, I T Giada Bigatti, I T Giancarlo Marinangeli, I T Gianfranca Cabiddu, U K Gillian Hirst, I T Giordano Fumagalli, I T Giorgia Caloro, I T Giorgina Piccoli, I T Giovanbattista Capasso, I T Giovanni Gambaro, I T Giuliana Tognarelli, I T Giuseppe Bonforte, I T Giuseppe Conte, I T Giuseppe Toscano, I T Goffredo Del Rosso, S E Gunilla Welander, P L Hanna Augustyniak-Bartosik, N L Hans Boots, D E Hans Schmidt-Gürtler, U K Hayley King, U K Helen McNally, D E Hendrik Schlee, N L Henk Boom, D E Holger Naujoks, U K Houda Masri-Senghor, U K Hugh Murtagh, U K Hugh Rayner, P L Ilona Miśkowiec-Wiśniewska, D E Ines Schlee, I T Irene Capizzi, S E Isabel Bascaran Hernandez, I T Ivano Baragetti, P L Jacek Manitius, U K Jane Turner, N L Jan-Willem Eijgenraam, N L Jeroen Kooman, D E Joachim Beige, P L Joanna Pondel, U K Joanne Wilcox, U K Jocelyn Berdeprado, D E Jochen Röthele, U K Jonathan Wong, N L Joris Rotmans, U K Joyce Banda, D E Justyna Mazur, D E Kai Hahn, P L Kamila Jędrzejak, P L Katarzyna Nowańska, D E Katja Blouin, D E Katrin Neumeier, U K Kirsteen Jones, D E Kirsten Anding-Rost, S E Knut-Christian Gröntoft, I T Lamberto Oldrizzi, U K Lesley Haydock, N L Liffert Vogt, U K Lily Wilkinson, I T Loreto Gesualdo, D E Lothar Schramm, I T Luigi Biancone, P L Łukasz Nowak, N L Maarten Raasveld, P L Magdalena Durlik, I T Manuela Magnano, N L Marc Vervloet, I T Marco Ricardi, U K Margaret Carmody, I T Maria Di Bari, I T Maria Laudato, I T Maria Luisa Sirico, S E Maria Stendahl, S E Maria Svensson, U K Maria Weetman, N L Marjolijn van Buren, U K Martin Joinson, I T Martina Ferraresi, U K Mary Dutton, N L Merel van Diepen, U K Michael Matthews, I T Michele Provenzano, D E Monika Hopf, I T Moreno Malaguti, D E Nadja Wuttke, U K Neal Morgan, I T Nicola Palmieri, D E Nikolaus Frischmuth, U K Nina Bleakley, I T Paola Murrone, U K Paul Cockwell, N L Paul Leurs, U K Paul Roderick, N L Pauline Voskamp, S E Pavlos Kashioulis, D E Pawlos Ichtiaris, N L Peter Blankestijn, D E Petra Kirste, D E Petra Schulz, U K Phil Mason, U K Philip Kalra, I T Pietro Cirillo, I T Pietro Dattolo, I T Pina Acampora, U K Rincy Sajith, I T Rita Nigro, I T Roberto Boero, I T Roberto Scarpioni, I T Rosa Sicoli, I T Rosella Malandra, D E Sabine Aign, D E Sabine Cäsar, N L Sadie van Esch, U K Sally Chapman, D E Sandra Biribauer, U K Santee Navjee, U K Sarah Crosbie, U K Sharon Brown, U K Sheila Tickle, D E Sherin Manan, D E Silke Röser, I T Silvana Savoldi, I T Silvio Bertoli, I T Silvio Borrelli, N L Siska Boorsma, D E Stefan Heidenreich, S E Stefan Melander, I T Stefania Maxia, I T Stefano Maffei, I T Stefano Mangano, D E Stephanie Palm, N L Stijn Konings, U K Suresh Mathavakkannan, D E Susanne Schwedler, D E Sylke Delrieux, D E Sylvia Renker, D E Sylvia Schättel, P L Szyszkowska Dorota, I T Teresa Cicchetti, P L Teresa Nieszporek, D E Theresa Stephan, D E Thomas Schmiedeke, D E Thomas Weinreich, D E Til Leimbach, I T Tiziana Rappa, S E Tora Almquist, D E Torsten Stövesand, D E Udo Bahner, S E Ulrika Jensen, I T Valentina Palazzo, I T Walter De Simone, D E Wolfgang Seeger, U K Ying Kuan, P L Zbigniew Heleniak, N L Zeynep Aydin

Affiliations

¹ ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands.
² UK Renal Registry, Southmead Hospital, Bristol, UK.
³ Department of Medicine, Division of Nephrology, University Hospital of Würzburg, Würzburg, Germany.
⁴ Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, CNR-IFC, Reggio Calabria, Italy.
⁵ Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
⁶ Department of Nephrology and Transplantation, Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
⁷ Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
⁸ Department of Clinical Sciences Intervention and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden.

PMID: 29905848
DOI: 10.1093/ndt/gfy155

Multicenter Study

Uraemic symptom burden and clinical condition in women and men of ≥65 years of age with advanced chronic kidney disease: results from the EQUAL study

Moniek W M van de Luijtgaarden et al. Nephrol Dial Transplant. 2019.

. 2019 Jul 1;34(7):1189-1196.

doi: 10.1093/ndt/gfy155.

Authors

Collaborators

EQUAL study investigators:
I T Adamasco Cupisti, I T Adelia Sagliocca, I T Alberto Ferraro, P L Aleksandra Musiała, I T Alessandra Mele, I T Alessandro Naticchia, I T Alex Còsaro, U K Alistair Woodman, I T Andrea Ranghino, I T Andrea Stucchi, S E Andreas Jonsson, D E Andreas Schneider, I T Angelo Pignataro, N L Anita Schrander, D E Anke Torp, U K Anna McKeever, P L Anna Szymczak, S E Anna-Lena Blom, I T Antonella De Blasio, I T Antonello Pani, I T Aris Tsalouichos, U K Asad Ullah, U K Barbara McLaren, N L Bastiaan van Dam, D E Beate Iwig, I T Bellasi Antonio, I T Biagio Raffaele Di Iorio, S E Björn Rogland, D E Boris Perras, I T Butti Alessandra, U K Camille Harron, S E Carin Wallquist, N L Carl Siegert, U K Carla Barrett, N L Carlo Gaillard, I T Cataldo Abaterusso, N L Charles Beerenhout, U K Charlotte O'Toole, I T Chiara Somma, D E Christian Marx, U K Christina Summersgill, D E Christof Blaser, I T Claudia D'alessandro, D E Claudia Emde, I T Claudia Zullo, I T Claudio Pozzi, U K Colin Geddes, N L Cornelis Verburgh, I T Daniela Bergamo, I T Daniele Ciurlino, I T Daria Motta, U K Deborah Glowski, U K Deborah McGlynn, S E Denes Vargas, D E Detlef Krieter, I T Domenico Russo, D E Dunja Fuchs, U K Dympna Sands, N L Ellen Hoogeveen, D E Ellen Irmler, S E Emöke Dimény, I T Enrico Favaro, D E Eva Platen, P L Ewelina Olczyk, N L Ewout Hoorn, I T Federica Vigotti, I T Ferruccio Ansali, I T Ferruccio Conte, I T Francesca Cianciotta, I T Francesca Giacchino, I T Francesco Cappellaio, I T Francesco Pizzarelli, S E Fredrik Sundelin, S E Fredrik Uhlin, I T Gaetano Greco, U K Geena Roy, I T Gaetana Porto, I T Giada Bigatti, I T Giancarlo Marinangeli, I T Gianfranca Cabiddu, U K Gillian Hirst, I T Giordano Fumagalli, I T Giorgia Caloro, I T Giorgina Piccoli, I T Giovanbattista Capasso, I T Giovanni Gambaro, I T Giuliana Tognarelli, I T Giuseppe Bonforte, I T Giuseppe Conte, I T Giuseppe Toscano, I T Goffredo Del Rosso, S E Gunilla Welander, P L Hanna Augustyniak-Bartosik, N L Hans Boots, D E Hans Schmidt-Gürtler, U K Hayley King, U K Helen McNally, D E Hendrik Schlee, N L Henk Boom, D E Holger Naujoks, U K Houda Masri-Senghor, U K Hugh Murtagh, U K Hugh Rayner, P L Ilona Miśkowiec-Wiśniewska, D E Ines Schlee, I T Irene Capizzi, S E Isabel Bascaran Hernandez, I T Ivano Baragetti, P L Jacek Manitius, U K Jane Turner, N L Jan-Willem Eijgenraam, N L Jeroen Kooman, D E Joachim Beige, P L Joanna Pondel, U K Joanne Wilcox, U K Jocelyn Berdeprado, D E Jochen Röthele, U K Jonathan Wong, N L Joris Rotmans, U K Joyce Banda, D E Justyna Mazur, D E Kai Hahn, P L Kamila Jędrzejak, P L Katarzyna Nowańska, D E Katja Blouin, D E Katrin Neumeier, U K Kirsteen Jones, D E Kirsten Anding-Rost, S E Knut-Christian Gröntoft, I T Lamberto Oldrizzi, U K Lesley Haydock, N L Liffert Vogt, U K Lily Wilkinson, I T Loreto Gesualdo, D E Lothar Schramm, I T Luigi Biancone, P L Łukasz Nowak, N L Maarten Raasveld, P L Magdalena Durlik, I T Manuela Magnano, N L Marc Vervloet, I T Marco Ricardi, U K Margaret Carmody, I T Maria Di Bari, I T Maria Laudato, I T Maria Luisa Sirico, S E Maria Stendahl, S E Maria Svensson, U K Maria Weetman, N L Marjolijn van Buren, U K Martin Joinson, I T Martina Ferraresi, U K Mary Dutton, N L Merel van Diepen, U K Michael Matthews, I T Michele Provenzano, D E Monika Hopf, I T Moreno Malaguti, D E Nadja Wuttke, U K Neal Morgan, I T Nicola Palmieri, D E Nikolaus Frischmuth, U K Nina Bleakley, I T Paola Murrone, U K Paul Cockwell, N L Paul Leurs, U K Paul Roderick, N L Pauline Voskamp, S E Pavlos Kashioulis, D E Pawlos Ichtiaris, N L Peter Blankestijn, D E Petra Kirste, D E Petra Schulz, U K Phil Mason, U K Philip Kalra, I T Pietro Cirillo, I T Pietro Dattolo, I T Pina Acampora, U K Rincy Sajith, I T Rita Nigro, I T Roberto Boero, I T Roberto Scarpioni, I T Rosa Sicoli, I T Rosella Malandra, D E Sabine Aign, D E Sabine Cäsar, N L Sadie van Esch, U K Sally Chapman, D E Sandra Biribauer, U K Santee Navjee, U K Sarah Crosbie, U K Sharon Brown, U K Sheila Tickle, D E Sherin Manan, D E Silke Röser, I T Silvana Savoldi, I T Silvio Bertoli, I T Silvio Borrelli, N L Siska Boorsma, D E Stefan Heidenreich, S E Stefan Melander, I T Stefania Maxia, I T Stefano Maffei, I T Stefano Mangano, D E Stephanie Palm, N L Stijn Konings, U K Suresh Mathavakkannan, D E Susanne Schwedler, D E Sylke Delrieux, D E Sylvia Renker, D E Sylvia Schättel, P L Szyszkowska Dorota, I T Teresa Cicchetti, P L Teresa Nieszporek, D E Theresa Stephan, D E Thomas Schmiedeke, D E Thomas Weinreich, D E Til Leimbach, I T Tiziana Rappa, S E Tora Almquist, D E Torsten Stövesand, D E Udo Bahner, S E Ulrika Jensen, I T Valentina Palazzo, I T Walter De Simone, D E Wolfgang Seeger, U K Ying Kuan, P L Zbigniew Heleniak, N L Zeynep Aydin

Affiliations

¹ ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands.
² UK Renal Registry, Southmead Hospital, Bristol, UK.
³ Department of Medicine, Division of Nephrology, University Hospital of Würzburg, Würzburg, Germany.
⁴ Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, CNR-IFC, Reggio Calabria, Italy.
⁵ Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
⁶ Department of Nephrology and Transplantation, Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
⁷ Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
⁸ Department of Clinical Sciences Intervention and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden.

PMID: 29905848
DOI: 10.1093/ndt/gfy155

Abstract

Background: The epidemiology and prognosis of chronic kidney disease (CKD) differ by sex. We aimed to compare symptom prevalence and the clinical state in women and men of ≥65 years of age with advanced CKD receiving routine nephrology care.

Methods: The European QUALity study on treatment in advanced chronic kidney disease (EQUAL) study follows patients from six European countries of ≥65 years of age years whose estimated glomerular filtration rate (eGFR) dropped to ≤20 mL/min/1.73 m2 for the first time during the last 6 months. The Dialysis Symptom Index was used to assess the prevalence and severity of 33 uraemic symptoms. Data on the clinical state at baseline were collected from medical records. Prevalence was standardized using the age distribution of women as the reference.

Results: The results in women (n = 512) and men (n = 967) did not differ with age (77.0 versus 75.7 years) or eGFR (19.0 versus 18.5). The median number of symptoms was 14 [interquartile range (IQR) 9-19] in women, and 11 (IQR 7-16) in men. Women most frequently reported fatigue {39% [95% confidence interval (CI) 34-45]} and bone/joint pain [37% (95% CI 32-42)] as severe symptoms, whereas more men reported difficulty in becoming sexually aroused [32% (95% CI 28-35)] and a decreased interest in sex [31% (95% CI 28-35)]. Anaemia [73% (95% CI 69-77) versus 85% (95% CI 82-87)] was less common in women than in men, as were smoking history and cardiovascular comorbidity. However, a diagnosis of liver disease other than cirrhosis, psychiatric disease and mild malnutrition were more common among women.

Conclusions: Women in secondary care with an incident eGFR ≤20 mL/min/1.73 m2 reported a higher symptom burden, while their clinical state was considered similar or even more favourable as compared with men.

Keywords: chronic kidney disease; elderly; sex; symptom burden; uraemic signs.

PubMed Disclaimer

Cited by

Self-management interventions for adult haemodialysis patients: a scoping review of randomized controlled trials.
Friedrich NK, Schmitt N, Hruby H, Kugler C. Friedrich NK, et al. BMC Nephrol. 2025 Jun 13;26(1):285. doi: 10.1186/s12882-025-04229-6. BMC Nephrol. 2025. PMID: 40514662 Free PMC article.
Kidney supportive care: an update of the current state of the art of palliative care in CKD patients.
Tavares APDS, Santos CGDS, Tzanno-Martins C, Barros Neto J, Silva AMMD, Lotaif L, Souza JVL. Tavares APDS, et al. J Bras Nefrol. 2021 Jan-Mar;43(1):74-87. doi: 10.1590/2175-8239-JBN-2020-0017. J Bras Nefrol. 2021. PMID: 32897286 Free PMC article. Review.
Differences in the epidemiology, management and outcomes of kidney disease in men and women.
Chesnaye NC, Carrero JJ, Hecking M, Jager KJ. Chesnaye NC, et al. Nat Rev Nephrol. 2024 Jan;20(1):7-20. doi: 10.1038/s41581-023-00784-z. Epub 2023 Nov 20. Nat Rev Nephrol. 2024. PMID: 37985869 Review.
Differences in physical symptoms between those with and without kidney disease: a comparative study across disease stages in a UK population.
Wilkinson TJ, Nixon DGD, Palmer J, Lightfoot CJ, Smith AC. Wilkinson TJ, et al. BMC Nephrol. 2021 Apr 22;22(1):147. doi: 10.1186/s12882-021-02355-5. BMC Nephrol. 2021. PMID: 33888089 Free PMC article.
Social isolation in chronic kidney disease and the role of mobility limitation.
Moorthi RN, Latham-Mintus K. Moorthi RN, et al. Clin Kidney J. 2019 Jan 14;12(4):602-610. doi: 10.1093/ckj/sfy134. eCollection 2019 Aug. Clin Kidney J. 2019. PMID: 31384455 Free PMC article.

See all "Cited by" articles

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
- Ovid Technologies, Inc.
- Silverchair Information Systems
Other Literature Sources
- scite Smart Citations
Medical
- MedlinePlus Health Information
Research Materials
- NCI CPTC Antibody Characterization Program
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Uraemic symptom burden and clinical condition in women and men of ≥65 years of age with advanced chronic kidney disease: results from the EQUAL study

Collaborators

Affiliations

Uraemic symptom burden and clinical condition in women and men of ≥65 years of age with advanced chronic kidney disease: results from the EQUAL study

Authors

Collaborators

Affiliations

Abstract

Similar articles

Cited by

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Research Materials

Miscellaneous

Abstract

Similar articles

Cited by

Publication types

MeSH terms

Related information

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Research Materials

Miscellaneous