Correlation between symptom distress and quality of life in patients with Chronic Kidney Disease Stage 5 undergoing hemodialysis in China: a multi-center cross-sectional study

Aim To explore the symptom distress and quality of life status of patients with Chronic Kidney Disease (CKD) Stage 5 undergoing hemodialysis in China, and their correlation. Methods The Dialysis Symptom Index (DSI) and the Kidney Disease Quality of Life Short Form (KDQOL-SF™ 1.3), two widely used assessment tools for hemodialysis patients, were used for evaluation. Results The patients reported an average of 13 symptoms. The most common symptoms were worrying (99.7%), sexual dysfunction (>90%), and trouble falling asleep (90.8%). The KDQOL-SF™ 1.3 showed that patients had lower scores in dimensions such as “Burden of Kidney Disease” and “Work Status,” while they had higher scores in the “Dialysis Staff Encouragement” and “Role Limitations - Emotional” dimensions. Univariate analysis revealed that age, education level, employment status, dialysis frequency, dialysis modality, primary disease, multiple comorbidities, complications (renal anemia), and polypharmacy were significantly associated with the total DSI score. Spearman’s rank correlation analysis showed a negative correlation between the total DSI score and each dimension of KDQOL-SF™ 1.3, with the strongest correlation found with the “Symptom/Problem List” dimension. Multivariate linear regression analysis indicated that age, education level, dialysis duration, dialysis modality, and primary disease (diabetic nephropathy) were independent influencing factors for the total DSI score. After controlling for confounding factors, the total DSI score remained independently negatively correlated with multiple dimensions of KDQOL-SF™ 1.3. Conclusions Symptom distress is negatively correlated with quality of life in Chinese CKD Stage 5 hemodialysis patients. Clinical attention should be given to symptom screening and management.