Table 2.
Risk of waitlist mortality by kidney disease symptom burden among kidney transplant candidates
| Exposure | Crude Subdistribution Hazard Ratios (95% Confidence Interval), n=1298 | Adjusted Subdistribution Hazard Ratios (95% Confidence Interval), n=1282 |
|---|---|---|
| Individual symptom scores (range 0–100, per 10-points worse) | ||
| Muscle soreness | 1.06 (1.01 to 1.11) | 1.07 (1.02 to 1.13) |
| Chest pain | 1.14 (1.05 to 1.24) | 1.18 (1.07 to 1.29) |
| Cramps | 1.04 (1.00 to 1.10) | 1.05 (1.00 to 1.10) |
| Pruritus | 1.00 (0.96 to 1.06) | 1.00 (0.95 to 1.06) |
| Xeroderma | 0.99 (0.94 to 1.04) | 0.99 (0.95 to 1.05) |
| Dyspnea | 1.05 (0.99 to 1.11) | 1.07 (1.01 to 1.14) |
| Dizziness | 0.99 (0.91 to 1.08) | 1.01 (0.93 to 1.11) |
| Anorexia | 1.04 (0.98 to 1.09) | 1.08 (1.02 to 1.14) |
| Fatigue | 1.02 (0.97 to 1.08) | 1.06 (1.01 to 1.12) |
| Numbness | 1.06 (1.01 to 1.12) | 1.05 (1.00 to 1.11) |
| Upset stomach | 1.02 (0.96 to 1.08) | 1.05 (0.99 to 1.12) |
| Site related (patients on dialysis only) | 0.99 (0.91 to 1.08) | 1.00 (0.91 to 1.10) |
| Overall symptom score (range 0–100) | ||
| Continuous score per 10-points worse | 1.10 (0.99 to 1.21) | 1.16 (1.05 to 1.29) |
| Symptom burden | ||
| Low | Reference | Reference |
| Medium | 1.24 (0.81 to 1.88) | 1.32 (0.87 to 2.00) |
| High | 1.36 (0.84 to 2.21) | 1.48 (0.91 to 2.40) |
| Very high | 1.35 (0.87 to 2.11) | 1.67 (1.06 to 2.62) |
Candidates were enrolled at evaluation for transplant. The individual and overall symptom scores ranged from zero to 100 points and were on the basis of self-reported burden of individual symptom/problem of kidney disease with five response options ranging from “not at all bothered” to “extremely bothered.” The individual symptom scores were transformed to a scale of 0–100 possible range, where a higher score represents lower burden. The overall symptom score was calculated by averaging across the 12 individual scores, so a higher symptom score represents a lower burden. Symptom burden was defined as very high: 0.0–71.0; high: 71.1–81.0; medium: 81.1–91.0; and low: 91.1–100.0. Crude subdistribution hazard ratios and adjusted subdistribution hazard ratios with 95% confidence intervals are presented from competing risks models (competing risk of transplantation). Associations that are statistically significant at P=0.05 are in bold. Adjusted models were adjusted for age at evaluation, sex, Black race, dialysis type, time on dialysis, body mass index, and cause of kidney failure.