Related Experiment Video
Updated: May 28, 2026
08:39
A Murine Model of Hemodialysis Access-Related Hand Dysfunction
Published on: May 31, 2022
Symptom Clusters and Longitudinal Progression in Chronic Hemodialysis Patients: A Prospective Single-Center Study
Naama Altura1, Gillie Gabay2, Ruth Israeli1
1Dialysis Unit "Ziv", Hadassah Ein-Kerem Medical Center, Jerusalem 91120, Israel.
Healthcare (Basel, Switzerland)
|May 27, 2026
Summary
Chronic hemodialysis patients experience evolving symptoms. Longitudinal analysis shows symptom clusters are unstable over time, requiring patient-centered care for better health outcomes.
Area of Science:
- Nephrology
- Symptom Science
- Patient-Reported Outcomes
Background:
- Chronic hemodialysis (HD) patients experience significant symptom burden impacting quality of life.
- Limited longitudinal research exists on symptom cluster dynamics and evolution in HD patients.
- Understanding symptom trajectories is crucial for effective patient management.
Purpose of the Study:
- To characterize and compare symptom clusters across body systems in chronic HD patients.
- To analyze symptom frequency and severity at three distinct time points.
- To investigate the longitudinal evolution of symptom profiles over one year.
Main Methods:
- Prospective longitudinal study of 69 chronic HD patients over 12 months.
- Self-reported data collected on 23 symptoms using validated measures (0-10 scale).
- Symptom progression and clustering analyzed via heat maps and principal component analysis.
Main Results:
- Baseline symptom burden included fatigue, perceived health, worry, and sleep disturbance.
- Longitudinal analysis revealed poor symptom cluster stability (ARI < 0.70) over 12 months.
- Gastrointestinal symptoms significantly decreased; fatigue and perceived health remained high burdens. Central venous catheter use correlated with higher pain, fatigue, and nausea; diabetes associated with dyspnea.
Conclusions:
- Chronic HD patients exhibit dynamic, multidimensional symptom burdens with significant temporal variations.
- Instability of symptom clusters highlights the need for routine, longitudinal assessment.
- Flexible, patient-centered management strategies are essential for optimizing care and supporting value-based healthcare.
Related Concept Videos
01:24Hemodialysis II: Procedure and Complications
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
01:24Chronic Kidney Disease II: Clinical Manifestations
Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
01:28Chronic Kidney Disease III: Interprofessional Care
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
01:25Chronic Kidney Disease I: Introduction
Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
01:25Hemodialysis I: Introduction
Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
01:25Hemodialysis III: Nursing Management
The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...