{"id":{"repo_id":"cape-town","oai_identifier":"oai:open.uct.ac.za:11427/42086"},"canonical_url":"https://search.dev.ndltd.org/etd/cape-town/oai:open.uct.ac.za:11427/42086","repository":{"repo_id":"cape-town","name":"University of Cape Town","base_url":"https://open.uct.ac.za/oai/request"},"display":{"title":"The prevalence and severity of the symptom burden in patients with End Stage Renal Disease (ESRD) in a resource limited setting","abstract":"Globally, kidney failure is Increasing. In South Africa, limited access to kidney replacement therapy (KRT) necessitates urgent improvement in kidney supportive and palliative care. Methods: This prospective, cross-sectional, mixed-method study was conducted at two Cape Town hospitals from June 2021 to June 2023. Participants with end-stage kidney failure (n=75) were categorized into three groups: receiving dialysis, on the waiting list, and ineligible for state-funded KRT (category 3). Data collection included demographics, comorbidities, and social circumstances. The Integrated Palliative care Outcome Scale Renal (IPOS-Renal) questionnaire assessed symptom burden, complemented by qualitative insights from open-ended interviews, which underwent thematic analysis. Results: The cohort was young, with a median age of 40 (33-45) years, and faced significant poverty, commonly experiencing weakness/lack of energy (64%). Patients on the waiting list and those in category 3 had a higher symptom burden. Category 3 patients had the highest prevalence of shortness of breath (p=0.006), dry mouth (p<0.001), poor mobility (p=0.007), and restless legs (p=0.038). Emotional symptoms were prevalent across all groups. Category 3 patients experienced the most severe physical symptoms, including shortness of breath (p=0.003), sore/dry mouth (p<0.001), drowsiness (p=0.028), and poor mobility (p<0.001). They also experienced the highest levels of personal anxiety (p<0.001), patient perception of family anxiety (p=0.037), and appointment time wastage (p=0.021). Qualitative findings highlighted concerns for families, fears about unfulfilled lives, and the need for better access to information. Conclusion: Limited literature exists on symptom burden in conservative kidney care with dialysis rationing. Recommendations advocate early multidisciplinary team involvement, improved patient and family support, and enhanced palliative care training.","abstract_html":"Globally, kidney failure is Increasing. In South Africa, limited access to kidney replacement therapy (KRT) necessitates urgent improvement in kidney supportive and palliative care. Methods: This prospective, cross-sectional, mixed-method study was conducted at two Cape Town hospitals from June 2021 to June 2023. Participants with end-stage kidney failure (n=75) were categorized into three groups: receiving dialysis, on the waiting list, and ineligible for state-funded KRT (category 3). Data collection included demographics, comorbidities, and social circumstances. The Integrated Palliative care Outcome Scale Renal (IPOS-Renal) questionnaire assessed symptom burden, complemented by qualitative insights from open-ended interviews, which underwent thematic analysis. Results: The cohort was young, with a median age of 40 (33-45) years, and faced significant poverty, commonly experiencing weakness/lack of energy (64%). Patients on the waiting list and those in category 3 had a higher symptom burden. Category 3 patients had the highest prevalence of shortness of breath (p=0.006), dry mouth (p&lt;0.001), poor mobility (p=0.007), and restless legs (p=0.038). Emotional symptoms were prevalent across all groups. Category 3 patients experienced the most severe physical symptoms, including shortness of breath (p=0.003), sore/dry mouth (p&lt;0.001), drowsiness (p=0.028), and poor mobility (p&lt;0.001). They also experienced the highest levels of personal anxiety (p&lt;0.001), patient perception of family anxiety (p=0.037), and appointment time wastage (p=0.021). Qualitative findings highlighted concerns for families, fears about unfulfilled lives, and the need for better access to information. Conclusion: Limited literature exists on symptom burden in conservative kidney care with dialysis rationing. Recommendations advocate early multidisciplinary team involvement, improved patient and family support, and enhanced palliative care training.","abstract_has_math":false,"creators":["Van Vuuren, Ane Jansen"],"institution":"Department of Medicine","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Huchon, Bianca"],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025","date_published":"2025","updated_at":"2026-07-22T22:23:17Z","subjects":["End Stage Renal Disease"],"languages":["en"],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/11427/42086","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Huchon, Bianca"]},{"key":"dc:creator","label":"Author","values":["Van Vuuren, Ane Jansen"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2025-11-03T09:21:55Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2025-11-03T09:21:55Z"]},{"key":"dc:date.issued","label":"Date","values":["2025"]},{"key":"dc:publisher.department","label":"Dc Publisher Department","values":["Department of Medicine"]},{"key":"dc:publisher.institution","label":"Dc Publisher Institution","values":["University of Cape Town"]},{"key":"dc:type","label":"Dc Type","values":["Thesis / Dissertation"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["Masters","MMed"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["End Stage Renal Disease"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/11427/42086"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Globally, kidney failure is Increasing. In South Africa, limited access to kidney replacement therapy (KRT) necessitates urgent improvement in kidney supportive and palliative care. Methods: This prospective, cross-sectional, mixed-method study was conducted at two Cape Town hospitals from June 2021 to June 2023. Participants with end-stage kidney failure (n=75) were categorized into three groups: receiving dialysis, on the waiting list, and ineligible for state-funded KRT (category 3). Data collection included demographics, comorbidities, and social circumstances. The Integrated Palliative care Outcome Scale Renal (IPOS-Renal) questionnaire assessed symptom burden, complemented by qualitative insights from open-ended interviews, which underwent thematic analysis. Results: The cohort was young, with a median age of 40 (33-45) years, and faced significant poverty, commonly experiencing weakness/lack of energy (64%). Patients on the waiting list and those in category 3 had a higher symptom burden. Category 3 patients had the highest prevalence of shortness of breath (p=0.006), dry mouth (p<0.001), poor mobility (p=0.007), and restless legs (p=0.038). Emotional symptoms were prevalent across all groups. Category 3 patients experienced the most severe physical symptoms, including shortness of breath (p=0.003), sore/dry mouth (p<0.001), drowsiness (p=0.028), and poor mobility (p<0.001). They also experienced the highest levels of personal anxiety (p<0.001), patient perception of family anxiety (p=0.037), and appointment time wastage (p=0.021). Qualitative findings highlighted concerns for families, fears about unfulfilled lives, and the need for better access to information. Conclusion: Limited literature exists on symptom burden in conservative kidney care with dialysis rationing. Recommendations advocate early multidisciplinary team involvement, improved patient and family support, and enhanced palliative care training."]},{"key":"dc:title","label":"Title","values":["The prevalence and severity of the symptom burden in patients with End Stage Renal Disease (ESRD) in a resource limited setting"]}]}],"canonical_facts":{"dc:contributor.advisor":["Huchon, Bianca"],"dc:creator":["Van Vuuren, Ane Jansen"],"dc:date.accessioned":["2025-11-03T09:21:55Z"],"dc:date.available":["2025-11-03T09:21:55Z"],"dc:date.issued":["2025"],"dc:description.abstract":["Globally, kidney failure is Increasing. In South Africa, limited access to kidney replacement therapy (KRT) necessitates urgent improvement in kidney supportive and palliative care. Methods: This prospective, cross-sectional, mixed-method study was conducted at two Cape Town hospitals from June 2021 to June 2023. Participants with end-stage kidney failure (n=75) were categorized into three groups: receiving dialysis, on the waiting list, and ineligible for state-funded KRT (category 3). Data collection included demographics, comorbidities, and social circumstances. The Integrated Palliative care Outcome Scale Renal (IPOS-Renal) questionnaire assessed symptom burden, complemented by qualitative insights from open-ended interviews, which underwent thematic analysis. Results: The cohort was young, with a median age of 40 (33-45) years, and faced significant poverty, commonly experiencing weakness/lack of energy (64%). Patients on the waiting list and those in category 3 had a higher symptom burden. Category 3 patients had the highest prevalence of shortness of breath (p=0.006), dry mouth (p<0.001), poor mobility (p=0.007), and restless legs (p=0.038). Emotional symptoms were prevalent across all groups. Category 3 patients experienced the most severe physical symptoms, including shortness of breath (p=0.003), sore/dry mouth (p<0.001), drowsiness (p=0.028), and poor mobility (p<0.001). They also experienced the highest levels of personal anxiety (p<0.001), patient perception of family anxiety (p=0.037), and appointment time wastage (p=0.021). Qualitative findings highlighted concerns for families, fears about unfulfilled lives, and the need for better access to information. Conclusion: Limited literature exists on symptom burden in conservative kidney care with dialysis rationing. Recommendations advocate early multidisciplinary team involvement, improved patient and family support, and enhanced palliative care training."],"dc:identifier.uri":["http://hdl.handle.net/11427/42086"],"dc:language.iso":["en"],"dc:publisher.department":["Department of Medicine"],"dc:publisher.institution":["University of Cape Town"],"dc:subject":["End Stage Renal Disease"],"dc:title":["The prevalence and severity of the symptom burden in patients with End Stage Renal Disease (ESRD) in a resource limited setting"],"dc:type":["Thesis / Dissertation"],"dc:type.qualificationlevel":["Masters","MMed"]},"updated_at":"2026-07-22T22:23:17Z"}