{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T22:41:49Z","timestamp":1788475309969,"version":"build-2803163510"},"reference-count":34,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T00:00:00Z","timestamp":1726617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: The aim of this study is to compare data from two cohorts separated by a 17-year interval. We assessed the prevalence and severity of symptoms with the \u201cdialysis symptom index\u201d in these two groups, recruited in 2007 and 2024, to determine how advancements in dialysis therapy have influenced the symptom burden\u2019s prevalence and severity. Methods: End-stage renal diseases patients receiving maintenance hemodialysis three times a week in the hemodialysis unit of the university hospital were recruited between February and March 2007. In May 2024, in the same unit, another population sample was recruited and studied, as in 2007. The Dialysis Symptom Index (DSI) was administered to each patient, during the dialysis treatment. The DSI is made up of 30 questions, each of which addresses a specific physical or emotional symptom. The total symptom burden score, representing the total number of symptoms reported as being present, and the total symptom severity score, which represents the sum of individual severity scores, were generated for each patient. Results: We studied 71 patients in 2007 and 61 patients in 2024. The demographic, clinical and laboratory characteristics of the two study populations did not differ significantly. The total symptom burden score did not differ significantly between 2007 and 2024. The prevalence of most symptoms was similar in the two groups. The prevalence of constipation, decreased interest in sex and difficulty in becoming sexually aroused was higher in 2024 than in 2007. The total symptom severity was similar in the two periods. The severity of most symptoms was similar in the two groups. The severity of decreased interest in sex and difficulty in becoming sexually aroused was higher in 2024 than in 2007. Conclusions: The present study shows that, 17 years apart, the prevalence and severity of the symptom burden in patients on maintenance hemodialysis did not change significantly. These results suggest that studies investigating the causes and the pathogenesis of symptoms of patients on maintenance hemodialysis are urgently needed in the next future, as well as studies on therapeutic strategies.<\/jats:p>","DOI":"10.3390\/jcm13185529","type":"journal-article","created":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T03:34:20Z","timestamp":1726716860000},"page":"5529","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Symptom Burden in Patients on Maintenance Hemodialysis: Prevalence and Severity 17 Years Apart"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1627-0235","authenticated-orcid":false,"given":"Maurizio","family":"Bossola","sequence":"first","affiliation":[{"name":"Servizio Emodialisi, Dipartimento di Scienze Mediche e Chirurgiche, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Policlinico Universitario Fondazione Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4188-9032","authenticated-orcid":false,"given":"Ilaria","family":"Mariani","sequence":"additional","affiliation":[{"name":"Servizio Emodialisi, Dipartimento di Scienze Mediche e Chirurgiche, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Policlinico Universitario Fondazione Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo Pasquale","family":"Piccinni","sequence":"additional","affiliation":[{"name":"Servizio Emodialisi, Dipartimento di Scienze Mediche e Chirurgiche, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"},{"name":"Policlinico Universitario Fondazione Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Spoliti","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina e Chirurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Di Stasio","sequence":"additional","affiliation":[{"name":"Policlinico Universitario Fondazione Agostino Gemelli IRCCS, 00168 Rome, Italy"},{"name":"Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1038\/s41581-022-00542-7","article-title":"Epidemiology of haemodialysis outcomes","volume":"18","author":"Bello","year":"2022","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_2","unstructured":"GBD Chronic Kidney Disease Collaboration (2020). Global, regional, and national burden of chronic kidney disease, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet, 395, 709\u2013733."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1159\/000468959","article-title":"Expanded Hemodialysis: A New Therapy for a New Class of Membranes","volume":"190","author":"Ronco","year":"2017","journal-title":"Contrib. Nephrol."},{"key":"ref_4","first-page":"I","article-title":"The Rise of Expanded Hemodialysis","volume":"44","author":"Ronco","year":"2017","journal-title":"Blood Purif."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1177\/136140960100600304","article-title":"Health-related quality of life assessment in end-stage renal failure","volume":"6","author":"Piillips","year":"2001","journal-title":"NT Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1136\/bmj.332.7541.563","article-title":"The burden of chronic kidney disease","volume":"332","author":"Hamer","year":"2006","journal-title":"BMJ"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1053\/j.ajkd.2019.08.026","article-title":"Perceived health and quality of life in patients with CKD, including those with kidney failure: Findings from National Surveys in France","volume":"75","author":"Legrand","year":"2020","journal-title":"Am. J. Kidney Dis."},{"key":"ref_8","first-page":"100187","article-title":"\u2018It\u2019s about what I\u2019m able to do\u2019: Using the capabilities approach to understand the relationship between quality of life and vascular access in patients with end-stage kidney failure","volume":"2","author":"Greenwood","year":"2022","journal-title":"Qual. Res. Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.1007\/s40620-022-01313-0","article-title":"Dialysis symptom index burden and symptom clusters in a prospective cohort of dialysis patients","volume":"35","author":"You","year":"2022","journal-title":"J. Nephrol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1007\/s11136-019-02349-9","article-title":"Quality of life in older adults receiving hemodialysis: A qualitative study","volume":"29","author":"Hall","year":"2020","journal-title":"Qual. Life Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2545","DOI":"10.1111\/jocn.13644","article-title":"Symptom clusters in patients receiving haemodialysis: A systematic review of observational studies","volume":"26","author":"Cao","year":"2017","journal-title":"J. Clin. Nurs."},{"key":"ref_12","first-page":"1059","article-title":"Symptom cluster science in chronic kidney disease: A literature review","volume":"41","author":"Lockwood","year":"2018","journal-title":"West. J. Nurs. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.jpainsymman.2020.01.004","article-title":"Distinct Symptom Experience Among Subgroups of Patients with ESRD Receiving Maintenance Dialysis","volume":"60","author":"Ng","year":"2020","journal-title":"J. Pain Symptom Manag."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.jpainsymman.2019.08.013","article-title":"Stability and impact of symptom clusters in end-stage renal disease patients undergoing dialysis","volume":"59","author":"Ng","year":"2020","journal-title":"J. Pain Symptom Manag."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"454","DOI":"10.2215\/CJN.08370816","article-title":"Nephrologists\u2019 Perspectives on Defining and Applying Patient-Centered Outcomes in Hemodialysis","volume":"12","author":"Tong","year":"2017","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Bossola, M., Di Napoli, A., Angelici, L., Bargagli, A.M., Cascini, S., Kirchmayer, U., Agabiti, N., Davoli, M., and Marino, C. (2023). Trend and determinants of mortality in incident hemodialysis patients of the Lazio region. BMC Nephrol., 24.","DOI":"10.1186\/s12882-023-03170-w"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1111\/j.1542-4758.2008.00307.x","article-title":"Cultural comparison of symptoms in patients on maintenance hemodialysis","volume":"12","author":"Weisbord","year":"2008","journal-title":"Hemodial. Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.jpainsymman.2009.07.003","article-title":"Undertreatment of symptoms inpatients on maintenance hemodialysis","volume":"39","author":"Claxton","year":"2010","journal-title":"J. Pain Symptom Manag."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"960","DOI":"10.2215\/CJN.00990207","article-title":"Renal provider recognition of symptoms in patients on maintenance hemodialysis","volume":"2","author":"Weisbord","year":"2007","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1111\/nep.12754","article-title":"Symptoms and their recognition in adult haemodialysis patients: Interactions with quality of life","volume":"22","author":"Raj","year":"2017","journal-title":"Nephrology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1053\/j.ajkd.2023.02.008","article-title":"Fatigue in Patients Receiving Maintenance Hemodialysis: A Review","volume":"82","author":"Bossola","year":"2023","journal-title":"Am. J. Kidney Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1038\/nrneph.2011.218","article-title":"Xerostomia in patients on chronic hemodialysis","volume":"8","author":"Bossola","year":"2012","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"689","DOI":"10.5301\/jn.5000042","article-title":"Symptoms of depression and anxiety over time in chronic hemodialysis patients","volume":"25","author":"Bossola","year":"2012","journal-title":"J. Nephrol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1038\/sj.ki.5001572","article-title":"Anorexia in hemodialysis patients: An update","volume":"70","author":"Bossola","year":"2006","journal-title":"Kidney Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1007\/s11255-018-1875-0","article-title":"Fatigue is associated with high prevalence and severity of physical and emotional symptoms in patients on chronic hemodialysis","volume":"50","author":"Bossola","year":"2018","journal-title":"Int. Urol. Nephrol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/j.kint.2023.05.019","article-title":"Managing the symptom burden associated with maintenance dialysis: Conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference","volume":"104","author":"Mehrotra","year":"2023","journal-title":"Kidney Int."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1038\/s41581-021-00396-5","article-title":"The challenge of insomnia for patients on haemodialysis","volume":"17","author":"Cukor","year":"2021","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1038\/ki.2013.454","article-title":"Uremic pruritus","volume":"87","author":"Mettang","year":"2015","journal-title":"Kidney Int."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"821","DOI":"10.2147\/TCRM.S262843","article-title":"Safe Use of Opioids in Chronic Kidney Disease and Hemodialysis Patients: Tips and Tricks for Non-Pain Specialists","volume":"16","author":"Coluzzi","year":"2020","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_30","first-page":"778","article-title":"Chronic prescription of antidepressant medication in patients with chronic kidney disease with and without kidney replacement therapy compared with matched controls in the Dutch general population","volume":"15","author":"Koning","year":"2021","journal-title":"Clin. Kidney J."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Bossola, M., Mariani, I., Antocicco, M., Pepe, G., Petrosino, A., and Di Stasio, E. (2024). Selective Serotonin Reuptake Inhibitors and Symptoms of Depression in Patients on Chronic Hemodialysis: A Systematic Review. J. Clin. Med., 13.","DOI":"10.3390\/jcm13113334"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"177","DOI":"10.7326\/M23-1794","article-title":"Effectiveness of Existing Insomnia Therapies for Patients Undergoing Hemodialysis: A Randomized Clinical Trial","volume":"177","author":"Mehrotra","year":"2024","journal-title":"Ann. Intern. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.semnephrol.2015.06.007","article-title":"Insomnia in Patients with Chronic Kidney Disease","volume":"35","author":"Lindner","year":"2015","journal-title":"Semin. Nephrol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"10","DOI":"10.5334\/tohm.752","article-title":"Restless Legs Syndrome in Chronic Kidney Disease\u2014A Systematic Review","volume":"13","author":"Safarpour","year":"2023","journal-title":"Tremor Other Hyperkinet Mov."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/18\/5529\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:58:57Z","timestamp":1760111937000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/18\/5529"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,18]]},"references-count":34,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["jcm13185529"],"URL":"https:\/\/doi.org\/10.3390\/jcm13185529","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,18]]}}}