Pattern of Symptom Burden and Quality of Life: A Cross-Sectional Comparative Study Among Hemodialysis and Non-Dialysis Patients with End-Stage Kidney Disease
Bharathi Naik, Shankar Prasad Nagaraju, Anuja Damani, Arun Ghoshal, Pankaj Singhai, Naveen Salins, Ravindra Prabhu Attur, Swathi Nayak Ammunje, Ajith M. Nayak, Mohan V. Bhojaraja, Srinivas Vinayak Shenoy, Shilna Muttickal Swaminathan, Dharshan Rangaswamy, Indu Ramachandra RaoBackground: Patients with end-stage kidney disease (ESKD) often experience significant symptom burden and reduced quality of life (QoL). This study compared these outcomes between hemodialysis (HD) and non-dialysis (ND) ESKD patients in India. Methods: A six-month cross-sectional study was conducted among 247 patients with ESKD aged ≥ 18 years, following Institutional Ethics Committee approval (IEC-214/2021). Symptom burden and QoL were assessed using the Edmonton Symptom Assessment System–Revised: Renal and EuroQol 5-Dimension 5-Level instruments. Results: HD patients reported a higher symptom burden than ND patients (81.3% vs. 65.8%), with fatigue being the most common symptom. They also had greater mobility impairment (63% vs. 45%) and lower EQ-5D-5L utility scores (0.69 ± 0.32 vs. 0.79 ± 0.27), indicating poorer QoL. Older age and lower education were associated with higher symptom burden, while poorer QoL was associated with older age, widowhood, lower education, and longer dialysis vintage (p < 0.05). Symptom burden was moderately correlated with poorer QoL (r = 0.60, p < 0.01). Conclusions: HD patients experience a greater symptom burden and poorer QoL than ND-ESKD patients. Routine symptom assessment and targeted symptom management may improve patient-centered outcomes.