A systematic review of symptoms experienced by children and young people with kidney failure.

Background: Kidney failure at any age has a significant impact on quality of life (QoL) but the overall symptom burden for children and young people (CYP) is poorly described. Kidney failure has no cure and whilst transplantation is the preferred management option, it is not always possible, with pa...

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Publicado en:Pediatric Nephrology Vol. 40; no. 1; pp. 53 - 69
Autores principales: Jacob, Zoe, Plumb, Lucy, Oni, Louise, Mitra, Siona, Reynolds, Ben
Formato: research systematic review tables/charts Journal Article
Publicado: Springer Nature Jan2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2025
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00467-024-06465-8
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        atl: A systematic review of symptoms experienced by children and young people with kidney failure.
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        au:
          Jacob, Zoe
          Plumb, Lucy
          Oni, Louise
          Mitra, Siona
          Reynolds, Ben
        affil: Dept. of Medical Paediatrics, Royal Aberdeen Children's Hospital, NHS Grampian, Aberdeen, UK
      sug:
        subj:
          Renal Insufficiency Complications
          Symptom Burden
          Terminally Ill Patients
          Human
          Systematic Review
          Child
          Kidney Failure, Chronic Complications
          Sleep Disorders Risk Factors
          Mental Disorders Risk Factors
          Gastrointestinal Diseases Risk Factors
          Skin Diseases Risk Factors
          Otorhinolaryngologic Diseases Risk Factors
          Nervous System Diseases Risk Factors
          Eye Diseases Risk Factors
          Restless Legs Risk Factors
          Disorders of Excessive Somnolence Risk Factors
          Depression Risk Factors
          Anxiety Risk Factors
          Nausea and Vomiting Risk Factors
          Abdominal Pain Risk Factors
          Eating Disorders Risk Factors
          Anorexia Risk Factors
          Headache Risk Factors
          Pruritus Risk Factors
          Child: 6-12 years
      ab: Background: Kidney failure at any age has a significant impact on quality of life (QoL) but the overall symptom burden for children and young people (CYP) is poorly described. Kidney failure has no cure and whilst transplantation is the preferred management option, it is not always possible, with patients requiring supportive care at the end of their lives. Aim: To use the literature to understand the symptom burden for CYP with kidney failure who are approaching end-of-life. Methods: Using three databases, a systematic literature review was performed to identify eligible studies to extract data on symptoms experienced in CYP aged < 21 years with kidney failure. Data extraction was completed by two authors using a pre-designed proforma. Study quality assessment was undertaken using the BMJ AXIS tool. Results: A total of 20,003 titles were screened to yielding 35 eligible studies including 2,862 CYP with chronic kidney disease (CKD), of whom 1,624 (57%) had CKD stage 5. The studies included a median of 30 (range 7–241) patients. Symptoms were subcategorised into eight groups: sleep, mental health, gastrointestinal, dermatology, ear, nose and throat (ENT), neurology, multiple symptoms, and ophthalmology. The prevalences of the most commonly reported symptoms were: restless leg syndrome 16.7–45%, sleep disordered breathing 20–46%, hypersomnia 14.3–60%, depression 12.5–67%, anxiety 5.3–34%, overall gastrointestinal symptoms 43–82.6%, nausea and vomiting 15.8–68.4%, abdominal pain 10.5–67.4%, altered appetite or anorexia 19–90%, xerosis 53.5–100%, pruritis 18.6–69%, headache 24–76.2% and ophthalmological symptoms 26%. Within each subgroup, the symptom definitions used were heterogeneous, the methods of assessment were varied and some symptoms, such as pain and constipation, were poorly represented. Conclusions: There is a marked lack of evidence relating to the symptom burden for CYP with CKD. This study highlights the high symptom prevalence, particularly in relation to sleep, mental health, headache, dermatological and gastrointestinal symptoms. There is a need for consensus recommendations on the evaluation and management of symptoms for CYP with CKD approaching end-of-life. PROSPERO ID: CRD42022346120.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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