Symptoms assessment tools are very important to evaluate symptoms in end stage renal disease, but there are any symptoms assessment tool to evaluate symptoms in ACKD in spanish population?
Symptoms of chronic kidney disease
Most people with CKD have no symptoms because the body can tolerate even a large reduction in kidney function.
In other words, we are born with a lot more kidney function than is necessary for survival. Kidney function is often sufficient if only one kidney is working. That is why people can give a kidney to someone needing a kidney transplant.
A change in kidney function is usually discovered through a routine blood or urine test. If you are diagnosed with kidney disease, your kidney function will be monitored with regular blood and urine tests, and treatment aims to keep any symptoms to a minimum.
If the kidneys continue to lose function and there is progression towards kidney failure (established renal failure or ERF), this will usually be tracked by blood tests and monitoring. If kidney failure does occur, the symptoms may include:
weight loss and poor appetite
swollen ankles, feet or hands (due to water retention)
shortness of breath
blood or protein in your urine (protein in your urine is not something you will notice as it can only be detected during a urine test)
an increased need to urinate, particularly at night
insomnia
itchy skin
muscle cramps
high blood pressure (hypertension)
nausea
erectile dysfunction in men (an inability to get or maintain an erection)
These are general symptoms and can be caused by many less serious conditions. Many of the symptoms above can be avoided if treatment begins at an early stage, before any symptoms appear
http://www.nhs.uk/Conditions/Kidney-disease-chronic/Pages/Symptoms.aspx
We must use symptoms assessment tool in ACKD (outcome measure), but is neccessary to cross-cultural adaptated many of the questionnaires to assess symptoms in this population
I agree with Dr. Aldallal, that a lot of - by itself - unspecific findings may occur. No single item is specific for chronic kidney disease, but the sum of many symptoms is indicative of progredient uremia.
As a comment, weight loss measured by kg or pounds may be misleading as muscle wasting may be "neutralized" by fluid retention and also body composition may change with loss of muscles and an increase in fat mass. Thus, the question on weight loss should always be accompanied by the question on loss of physical function and general strenght.
To this moment we may use standarised tools to assess symptom control in this illness, we may consider using several scales but the question is: do we need to develop a specific tool to assess these in ACKD? I think that we may use the same tools to assess unique symptoms as it may be pain, for instance Edmonton scale; but in order to have a full vision of a patient suffering ACKD we may use an addressed one to this specific background.
Illness trajectories are different, prevalence of symptoms also, so this is a logical need but evidence is needed.
Language versions are always needed when we want to use an original tool based in a different language, this is a mandatory question in research field
The problem with CKD is that it is asymptomatic till the advanced stages . Therefore , the staging of CKD is based on eGFR based on serum creatinine . Diabetes & hypertension are the common causes & regular evaluation helps us in staging serum creatinine . Ali Aldalall has given the common symptoms in advanced CKD . In many young patients , the symptoms of CKD are non specific and hence ,the diagnosis of CKD is missed , if tests are not done . In addition , in developing countries , dialysis is done only when patients become symptomatic . It is essential for clinicians to be aware of these symptoms & do the blood tests to diagnose CKD .
The indication to start renal replacement therapy (RRT) is mainly derived from clinical symptoms. Early start of RRT has been shown to have no advantage. The only means to rely on blood tests to start RRT is symptomatic hyperkalemia or very severe metabolic acidosis.
I think that all the Colleagues attending to this question have fully replied, according to different but exact points of view. My personal experience confirms that in the largest part of persons, chronic kidney disease even progressing versus the end stage does not show particular symptoms, with the exception of few diseases showing physical symptoms as edema in diseases characterized by heavy proteinuria. Its is more probable to check a renal chronic disease when the patient is followed by a different disease frequently inducing renal damage, as well known for diabetes or because coming from a family affected by an hereditary disease like polycystic kidney.
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