International Journal of Clinical Science and Medical Research

Background: Patients with end-stage renal disease (ESRD) suffer from a wide range of burdensome symptoms that persist despite adequate dialysis as measured by standard solute clearance parameters. Patient-reported outcome measures (PROMs) offer a structured approach to systematically identify and address this symptom burden.

Methods: A cross-sectional descriptive study was conducted in the nephrology department of CHU Ibn Rochd, Casablanca. Thirty-three patients on regular hemodialysis for at least one year were included. Demographic, clinical, and biochemical data were collected, and comorbidity burden was assessed using the Charlson Comorbidity Index. Symptom burden was evaluated using the IPOS-Renal questionnaire, which covers 15 physical symptoms and emotional items scored on a 5-point scale (0–4) over the preceding 7 days. Statistical analyses were performed using SPSS, with significance set at p < 0.05.

Results: The mean age was 55.4 ± 11.5 years; 40% were female. The most prevalent moderate-to-severe symptoms (≥ 2) were fatigue/lack of energy (~70%), sleep disturbances (~64%), pruritus (~61%), somnolence (~52%), restless legs (~49%), decreased appetite (~45%), and pain (~39%). Anxiety/worry was reported at a moderate-to-severe level in ~55% of patients. Total IPOS score correlated positively with the Charlson Comorbidity Index (ρ ≈ +0.42, p ≈ 0.015) and negatively with serum albumin (ρ ≈ –0.36, p ≈ 0.041).

Conclusion: The symptom burden in hemodialysis patients remains high despite dialysis adequacy. Fatigue, sleep disorders, and pruritus are the most frequent and distressing complaints. Symptom load is associated with comorbidity and nutritional status, highlighting the need for an integrated management approach combining symptom control, nutritional support, and comorbidity management.

patient-reported outcomes; chronic kidney disease; hemodialysis; IPOS-Renal; symptom burden; quality of life; pruritus; fatigue; Charlson Comorbidity Index

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