For older adults with kidney failure, symptom burden worsens in the year before initiation of dialysis and
stabilizes thereafter, according to a study published in the Clinical Journal of the American Society of
Nephrology. Esther N.M. de Rooij, MD, and colleagues examined the course of total and individual symptom number and burden before and after starting dialysis in patients aged 65 and older with an incident eGFR of 20 mL/min/1.73 m2 or lower. Symptoms were assessed every 6 months using the dialysis symptom index (DSI). Data were included for 456 incident dialysis patients who completed at least one DSI in the year before or after dialysis. Symptom number increased +3.6 and symptom burden increased +13.3 in the year before dialysis initiation. In the year after, symptom number and burden decreased −0.9 and −5.9, respectively. The highest prevalence rates for symptoms were seen for “fatigue” (81%), “decreased interest in sex” (69%), and “difficulty becoming sexually aroused” (68%) at dialysis initiation.