Symptom Burden among Latino Patients with End-Stage Renal Disease and Access to Standard or Emergency-Only Hemodialysis

J Palliat Med. 2018 Sep;21(9):1329-1333. doi: 10.1089/jpm.2017.0663. Epub 2018 May 30.

Abstract

Background: Patients with end-stage renal disease (ESRD) have a high symptom burden and this negatively impacts health-related quality of life. Little is known about the symptom burden of Latinos with ESRD and variable access to hemodialysis.

Objective: To estimate the symptom burden of Latinos with ESRD and access to standard or emergency-only hemodialysis.

Design/setting/subjects: Observational descriptive study of Latino adults with ESRD receiving standard or emergency-only hemodialysis. Patients completed the Edmonton Symptom Assessment System Revised: Renal (ESAS-r:Renal). We used descriptive statistics and propensity score adjustment to conduct the analysis.

Measurement: ESAS-r:Renal.

Results: Participants (N = 67) had a mean age of 58 years (standard deviation [SD] ±13) and a mean Charlson Comorbidity Index of 6.6 ± 2.5, and had been on hemodialysis a mean of 42 months (SD ±43). On average, Latinos with ESRD experienced 7 (SD ±3) symptoms with a mean of 5 ± 3 symptoms reported as moderate or severe. After adjusting for propensity score, emergency-only hemodialysis patients reported experiencing more nausea compared to standard hemodialysis patients (odds ratio 8.95, 95% confidence interval: 1.17-68.31, p = 0.03).

Conclusion: Latinos with ESRD have a high symptom burden and compared to patients with standard hemodialysis, patients who rely on emergency-only hemodialysis report more nausea. A national treatment strategy that provides standard hemodialysis for undocumented immigrants with ESRD is an important next step.

Keywords: Latino; end-stage renal disease; ethnic minority; health disparities; hemodialysis; quality of life.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Colorado
  • Comorbidity
  • Female
  • Health Services Accessibility*
  • Hispanic or Latino*
  • Humans
  • Kidney Failure, Chronic / ethnology*
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Propensity Score
  • Quality of Life
  • Renal Dialysis*
  • Symptom Flare Up