Symptom burden and PROs in kidney transplant recipients

Results from a cross-sectional analysis of the TransplantLines Biobank and Cohort Study (NCT03272841), evaluating symptom burden and patient-reported outcomes (PROs) in stable kidney transplant recipients (N = 936) ≥1 year after transplant, were published in Kidney Medicine by Riemersma et al. The objective was to identify the most frequent and distressing symptoms, with exploratory analyses stratified by sex, age (<65 years vs ≥65 years), and time since transplantation (<2 years vs ≥2 years). Symptom distress and occurrence were assessed through relative to an identified distribution integral transformation (ridit) analyses.

Key data: Based on ridit scores, the most frequently reported symptoms were tiredness (0.724), bruises (0.718), and lack of energy (0.688); the most distressing symptoms were menstrual problems (0.679), impotence (0.654), and joint pain (0.611). In age- and sex-adjusted analyses, higher symptom burden was associated with female sex (p < 0.001), worse nutritional status (p < 0.001), anemia (p = 0.01), cyclosporine use (p = 0.005), proton pump inhibitor (PPI) use (p < 0.001), and longer time since transplant (p = 0.01). Higher symptom burden was associated with medication non-adherence, depression and anxiety symptoms, lower societal participation, and lower physical and mental health-related quality of life (HRQoL).

Key learning: High symptom burden in stable kidney transplant recipients is associated with multiple PROs, highlighting the importance of routine and proactive symptom assessment.