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Symptom scores (0\u2013100) at evaluation and admission for transplantation were calculated using the Kidney Disease Quality of Life Short-Form Survey, where lower scores represent greater burden, and burden was categorized as very high: 0.0\u201371.0; high: 71.1\u201381.0; medium: 81.1\u201391.0; and low: 91.1\u2013100.0. We estimated adjusted waitlist mortality risk (competing risks regression), change in symptoms between evaluation and transplantation (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =190), and post-transplantation symptom score trajectories (mixed effects models).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At evaluation, candidates reported being moderately to extremely bothered by fatigue (32%), xeroderma (27%), muscle soreness (26%), and pruritus (25%); 16% reported high and 21% reported very high symptom burden. Candidates with very high symptom burden were at greater waitlist mortality risk (adjusted subdistribution hazard ratio, 1.67; 95% confidence interval, 1.06 to 2.62). By transplantation, 34% experienced an increased symptom burden, whereas 42% remained unchanged. The estimated overall symptom score was 82.3 points at transplantation and 90.6 points at 3 months (10% improvement); the score increased 2.75 points per month (95% confidence interval, 2.38 to 3.13) from 0 to 3 months, and plateaued (\u22120.06 points per month; 95% confidence interval, \u22120.30 to 0.18) from 3 to 12 months post-transplantation. There were early (first 3 months) improvements in nine of 11 symptoms; pruritus (23% improvement) and fatigue (21% improvement) had the greatest improvements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among candidates, very high symptom burden was associated with waitlist mortality, but for those surviving and undergoing kidney transplantation, symptoms improved.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.19031220","type":"journal-article","created":{"date-parts":[[2021,6,18]],"date-time":"2021-06-18T15:35:11Z","timestamp":1624030511000},"page":"1083-1093","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":29,"title":["Kidney Disease Symptoms before and after Kidney Transplantation"],"prefix":"10.2215","volume":"16","author":[{"given":"Kathryn","family":"Taylor","sequence":"first","affiliation":[{"name":"Johns Hopkins University School of Nursing, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1441-3589","authenticated-orcid":false,"given":"Nadia M.","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9620-7361","authenticated-orcid":false,"given":"Xiaomeng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhan","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen","family":"Rosello","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sneha","family":"Kunwar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Butz","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silas P.","family":"Norman","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, University of Michigan, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3425-5776","authenticated-orcid":false,"given":"Deidra C.","family":"Crews","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko I.","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology and Hypertension, MedStar Georgetown University Hospital, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aarti","family":"Mathur","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorry L.","family":"Segev","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7222-4666","authenticated-orcid":false,"given":"Tariq","family":"Shafi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland"},{"name":"Department of Medicine, Division of Nephrology, University of Mississippi Medical Center, Jackson, Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3013-925X","authenticated-orcid":false,"given":"Mara A.","family":"McAdams-DeMarco","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,7]]},"reference":[{"key":"B1-20241015","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1053\/j.ackd.2006.10.001","article-title":"The prevalence of symptoms in end-stage renal disease: A systematic review","volume":"14","author":"Murtagh","year":"2007","journal-title":"Adv Chronic Kidney Dis"},{"key":"B2-20241015","doi-asserted-by":"crossref","first-page":"2656","DOI":"10.1093\/ndt\/gfq763","article-title":"Patients\u2019 perspective of haemodialysis-associated symptoms","volume":"26","author":"Caplin","year":"2011","journal-title":"Nephrol Dial 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