biostudies-literatureFaye MGlaxoSmithKlineAgence Nationale de la RechercheRecherche CliniqueMSD FranceFresenius Medical CareThe InsermMerck Sharp &amp; DohmeProgramme hospitalier de recherche cliniqueSanofi1588-1597https://www.ebi.ac.uk/biostudies/studies/S-EPMC9718050biostudies-literatureUnknown17(11)<h4>Background and objectives</h4>Late stages of CKD are characterized by significant symptom burden. This study aimed to identify subgroups within the 5-year trajectories of symptom evolution in patients with CKD and to describe associated patient characteristics and outcomes.<h4>Design, setting, participants, & measurements</h4>Among 2787 participants (66% men) with eGFR <60 ml/min per 1.73 m² enrolled in the CKD-Renal Epidemiology and Information Network (CKD-REIN) cohort study from July 2013 to May 2016, we assessed symptoms annually using the Kidney Disease Quality of Life-36 (KDQOL-36) questionnaire until December 2020. A total of 9121 measures were reported over follow-up; all participants had symptoms scored for at least one time point. We used a joint latent class-mixed model to distinguish profiles of symptom trajectories.<h4>Results</h4>Patient mean age (±SD) at baseline was 67±13 years, and mean eGFR was 33±13 ml/min per 1.73 m². The prevalence of each symptom ranged from 24% (chest pain) to 83% (fatigue), and 98% of participants reported at least one symptom. After a median (interquartile range) follow-up of 5.3 (3.4-6.0) years, 690 participants initiated KRT, and 490 died before KRT. We identified two profiles of symptom trajectories: a "worse symptom score and worsening trajectory" in 31% of participants, characterized by a low initial symptom score that worsened more than ten points over time, and a "better symptom score and stable trajectory" in 69% of participants, characterized by a high initial score that remained stable. Participants in the worse symptom score and worsening trajectory group had more risk factors for CKD progression at baseline, worse quality of life, and a higher risk of KRT and death before KRT than other participants.<h4>Conclusions</h4>This study highlights a significant worsening of symptoms in about one third of the participants, whereas the majority reported low symptom severity throughout the study.Clinical journal of the American Society of Nephrology : CJASNFive-Year Symptom Trajectories in Nondialysis-Dependent CKD Patients.PMC9718050ANR-IA-COH-2012/3731Legrand KLiabeuf SMassy ZACKD-REIN Study GroupFouque DLe Gall LSpeyer ELeffondre KAyav CAlencar de Pinho NFaye MPecoits Filho RLaville MJacquelinet CStengel BFrimat LOmorou AYCombe CfalseFive-Year Symptom Trajectories in Nondialysis-Dependent CKD Patients.<h4>Background and objectives</h4>Late stages of CKD are characterized by significant symptom burden. This study aimed to identify subgroups within the 5-year trajectories of symptom evolution in patients with CKD and to describe associated patient characteristics and outcomes.<h4>Design, setting, participants, & measurements</h4>Among 2787 participants (66% men) with eGFR <60 ml/min per 1.73 m² enrolled in the CKD-Renal Epidemiology and Information Network (CKD-REIN) cohort study from July 2013 to May 2016, we assessed symptoms annually using the Kidney Disease Quality of Life-36 (KDQOL-36) questionnaire until December 2020. A total of 9121 measures were reported over follow-up; all participants had symptoms scored for at least one time point. We used a joint latent class-mixed model to distinguish profiles of symptom trajectories.<h4>Results</h4>Patient mean age (±SD) at baseline was 67±13 years, and mean eGFR was 33±13 ml/min per 1.73 m². The prevalence of each symptom ranged from 24% (chest pain) to 83% (fatigue), and 98% of participants reported at least one symptom. After a median (interquartile range) follow-up of 5.3 (3.4-6.0) years, 690 participants initiated KRT, and 490 died before KRT. We identified two profiles of symptom trajectories: a "worse symptom score and worsening trajectory" in 31% of participants, characterized by a low initial symptom score that worsened more than ten points over time, and a "better symptom score and stable trajectory" in 69% of participants, characterized by a high initial score that remained stable. Participants in the worse symptom score and worsening trajectory group had more risk factors for CKD progression at baseline, worse quality of life, and a higher risk of KRT and death before KRT than other participants.<h4>Conclusions</h4>This study highlights a significant worsening of symptoms in about one third of the participants, whereas the majority reported low symptom severity throughout the study.2022-01-01T00:00:00Z2022 Nov2026-05-28T22:36:21.191Z2026-04-08T03:23:59.71ZS-EPMC97180503630713610.2215/CJN.0614052210.2215/cjn.06140522