Prevalencia y evaluación de síntomas en enfermedad renal crónica avanzada

Abstract

The patient with advanced chronic kidney disease (ACKD) has a high symptom burden that contribute to increased suffering and diminish their quality of life. The use of symptom assessment tools is essential for the control of symptoms. The aim of this review is to obtain a contrasted vision of the instruments commonly used to assess symptoms in ACKD, making a description of the prevalence of symptoms in this population. Method: A review of the literature on studies in which an instrument is used to measure the intensity of several symptoms in patients with ACKD was undertaken. The search was conducted in PubMed, Cochrane, SciELO and TESEO. Inclusion criteria were: studies in patients with ACKD, evaluating symptoms with an assessment tool, and also indicate the prevalence of various symptoms. Results: The instruments identified were the Memorial Symptom Assessment Scale Short Form (MSAS-SF), the Dialysis Symptom Index (DSI), the Edmonton Symptom Assessment System (ESAS) and the Palliative Care Outcome Scale-Symptoms Kidney (POS-S RENAL). In adult patients with ACKD undergoing renal replacement therapy with hemodialysis and peritoneal dialysis, the most prevalent symptoms were fatigue, pruritus, constipation, anorexia, pain, sleep disturbance, anxiety, dyspnea, nausea, restless legs, and depression. These symptoms were similar in patients with renal conservative management, and showed a common pattern to the symptoms of others advanced diseases. We conclude that we need to research about the prevalence and evaluation of symptoms in this population, and a systematic use of specific instruments for evaluating symptoms as an outcome measure is necessary.