The prevalence and severity of the symptom burden in patients with End Stage Renal Disease (ESRD) in a resource limited setting
| dc.contributor.advisor | Huchon, Bianca | |
| dc.contributor.author | Van Vuuren, Ane Jansen | |
| dc.date.accessioned | 2025-11-03T09:21:55Z | |
| dc.date.available | 2025-11-03T09:21:55Z | |
| dc.date.issued | 2025 | |
| dc.date.updated | 2025-11-03T09:15:05Z | |
| dc.description.abstract | Globally, kidney failure is Increasing. In South Africa, limited access to kidney replacement therapy (KRT) necessitates urgent improvement in kidney supportive and palliative care. Methods: This prospective, cross-sectional, mixed-method study was conducted at two Cape Town hospitals from June 2021 to June 2023. Participants with end-stage kidney failure (n=75) were categorized into three groups: receiving dialysis, on the waiting list, and ineligible for state-funded KRT (category 3). Data collection included demographics, comorbidities, and social circumstances. The Integrated Palliative care Outcome Scale Renal (IPOS-Renal) questionnaire assessed symptom burden, complemented by qualitative insights from open-ended interviews, which underwent thematic analysis. Results: The cohort was young, with a median age of 40 (33-45) years, and faced significant poverty, commonly experiencing weakness/lack of energy (64%). Patients on the waiting list and those in category 3 had a higher symptom burden. Category 3 patients had the highest prevalence of shortness of breath (p=0.006), dry mouth (p<0.001), poor mobility (p=0.007), and restless legs (p=0.038). Emotional symptoms were prevalent across all groups. Category 3 patients experienced the most severe physical symptoms, including shortness of breath (p=0.003), sore/dry mouth (p<0.001), drowsiness (p=0.028), and poor mobility (p<0.001). They also experienced the highest levels of personal anxiety (p<0.001), patient perception of family anxiety (p=0.037), and appointment time wastage (p=0.021). Qualitative findings highlighted concerns for families, fears about unfulfilled lives, and the need for better access to information. Conclusion: Limited literature exists on symptom burden in conservative kidney care with dialysis rationing. Recommendations advocate early multidisciplinary team involvement, improved patient and family support, and enhanced palliative care training. | |
| dc.identifier.apacitation | Van Vuuren, A. J. (2025). <i>The prevalence and severity of the symptom burden in patients with End Stage Renal Disease (ESRD) in a resource limited setting</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Medicine. Retrieved from http://hdl.handle.net/11427/42086 | en_ZA |
| dc.identifier.chicagocitation | Van Vuuren, Ane Jansen. <i>"The prevalence and severity of the symptom burden in patients with End Stage Renal Disease (ESRD) in a resource limited setting."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Medicine, 2025. http://hdl.handle.net/11427/42086 | en_ZA |
| dc.identifier.citation | Van Vuuren, A.J. 2025. The prevalence and severity of the symptom burden in patients with End Stage Renal Disease (ESRD) in a resource limited setting. . University of Cape Town ,Faculty of Health Sciences ,Department of Medicine. http://hdl.handle.net/11427/42086 | en_ZA |
| dc.identifier.ris | TY - Thesis / Dissertation AU - Van Vuuren, Ane Jansen AB - Globally, kidney failure is Increasing. In South Africa, limited access to kidney replacement therapy (KRT) necessitates urgent improvement in kidney supportive and palliative care. Methods: This prospective, cross-sectional, mixed-method study was conducted at two Cape Town hospitals from June 2021 to June 2023. Participants with end-stage kidney failure (n=75) were categorized into three groups: receiving dialysis, on the waiting list, and ineligible for state-funded KRT (category 3). Data collection included demographics, comorbidities, and social circumstances. The Integrated Palliative care Outcome Scale Renal (IPOS-Renal) questionnaire assessed symptom burden, complemented by qualitative insights from open-ended interviews, which underwent thematic analysis. Results: The cohort was young, with a median age of 40 (33-45) years, and faced significant poverty, commonly experiencing weakness/lack of energy (64%). Patients on the waiting list and those in category 3 had a higher symptom burden. Category 3 patients had the highest prevalence of shortness of breath (p=0.006), dry mouth (p<0.001), poor mobility (p=0.007), and restless legs (p=0.038). Emotional symptoms were prevalent across all groups. Category 3 patients experienced the most severe physical symptoms, including shortness of breath (p=0.003), sore/dry mouth (p<0.001), drowsiness (p=0.028), and poor mobility (p<0.001). They also experienced the highest levels of personal anxiety (p<0.001), patient perception of family anxiety (p=0.037), and appointment time wastage (p=0.021). Qualitative findings highlighted concerns for families, fears about unfulfilled lives, and the need for better access to information. Conclusion: Limited literature exists on symptom burden in conservative kidney care with dialysis rationing. Recommendations advocate early multidisciplinary team involvement, improved patient and family support, and enhanced palliative care training. DA - 2025 DB - OpenUCT DP - University of Cape Town KW - End Stage Renal Disease LK - https://open.uct.ac.za PB - University of Cape Town PY - 2025 T1 - The prevalence and severity of the symptom burden in patients with End Stage Renal Disease (ESRD) in a resource limited setting TI - The prevalence and severity of the symptom burden in patients with End Stage Renal Disease (ESRD) in a resource limited setting UR - http://hdl.handle.net/11427/42086 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/42086 | |
| dc.identifier.vancouvercitation | Van Vuuren AJ. The prevalence and severity of the symptom burden in patients with End Stage Renal Disease (ESRD) in a resource limited setting. []. University of Cape Town ,Faculty of Health Sciences ,Department of Medicine, 2025 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/42086 | en_ZA |
| dc.language.iso | en | |
| dc.language.rfc3066 | eng | |
| dc.publisher.department | Department of Medicine | |
| dc.publisher.faculty | Faculty of Health Sciences | |
| dc.publisher.institution | University of Cape Town | |
| dc.subject | End Stage Renal Disease | |
| dc.title | The prevalence and severity of the symptom burden in patients with End Stage Renal Disease (ESRD) in a resource limited setting | |
| dc.type | Thesis / Dissertation | |
| dc.type.qualificationlevel | Masters | |
| dc.type.qualificationlevel | MMed |