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Decoding hemodialysis patients' symptoms: navigating the complexity
Hoda Mahmoud Mohammad Abdulaziz1, Rasha Mahmoud1, Ahmed Mohamed Naguib Attiya2
1Mansoura Nephrology and Dialysis Unit (MNDU), Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Journal of Nephrology
|May 26, 2026
Summary
Hemodialysis patients experience significant symptom burden, averaging nine symptoms, impacting quality of life. Identifying core symptoms like nervousness and worry is crucial for improving patient care and well-being.
Area of Science:
- Nephrology
- Patient-Reported Outcomes
- Symptom Science
Background:
- Hemodialysis (HD) patients commonly face quality-of-life-reducing symptoms.
- Understanding symptom clusters and core symptoms is vital for effective patient management.
- This study investigated symptom dimensions, factors, and relationships in HD patients.
Purpose of the Study:
- To assess the diverse symptoms experienced by hemodialysis patients.
- To identify symptom clusters, core symptoms, and their interrelationships.
- To determine factors predicting higher symptom burden in this population.
Main Methods:
- A cross-sectional study involving 1156 hemodialysis patients across 27 Egyptian centers.
- Data collected via interviews and medical record reviews, utilizing the Chronic Kidney Disease Symptom Burden Index (CKD-SBI).
- Network and principal component analyses identified core and cluster symptoms; logistic regression pinpointed predictors of symptom burden.
Main Results:
- HD patients reported an average of 9 symptoms, with bone/joint pain, fatigue, and muscle cramps being most prevalent.
- Seven distinct symptom clusters were identified, with 'feeling nervous' and 'worrying' emerging as core symptoms.
- Predictors of increased symptom burden included sex, residence, prior transplantation, medication use, functional status, comorbidity index, and hemoglobin levels.
Conclusions:
- Symptom burden in hemodialysis patients is multifaceted and significantly affects well-being.
- Targeted interventions are necessary to alleviate symptom burden and enhance the quality of life for HD patients.
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