Abstract: 【Abstract】Objective To investigate the symptoms in maintenance hemodialysis (MHD) patients in three tertiary hospitals in Shenzhen, and to put forward the strategies for symptom management based on the presentations of the MHD patients. Methods A total of 368 patients with chronic kidney disease undergoing MHD at outpatient clinics from April 2017 to October 2017 were recruited using a convenient sampling method. General information questionnaire and symptom assessment scale for dialysis were used for a comprehensive investigation of the symptoms in MHD patients. Results The total symptom rate was 81.88% and the rate of various symptoms was 16.44～79.19% in MHD patients. Among the 30 symptoms, different symptoms were different in case number (χ2=631.383, P<0.001), frequency (t=42.651, P<0.001), severity (χ2=1070.703, P<0.001), and annoyances and troubles caused by the symptom (t=101.040, P<0.001). Stratified analyses of the MHD patients with different symptoms showed that gender (χ2=13.288, P=0.003), age (χ2=10.305, P=0.006), dialysis age (χ2=80.144, P＜0.001), dialysis frequency (χ2=48.033, P＜0.001), dialysis mode (χ2=114.949, P＜0.001) and primary kidney disease (χ2=55.068, P＜0.001) were significantly different in these MHD patients. The incidence of dry skin was significantly different, relating to gender (χ2=4.797, P=0.029), age (χ2=46.846, P＜0.001), dialysis age (χ2=52.661, P＜0.001), dialysis frequency (χ2=14.282, P=0.001), dialysis mode (χ2=74.599, P＜0.001), and primary disease (χ2=6.031, P=0.014) of the MHD patients. The inci- dence of pruritus was significantly different, relating to dialysis frequency (χ2=6.200, P=0.045) and dialysis mode (χ2=55.886, P＜0.001) of the MHD patients. The incidence of anxiety was significantly different, relating to age (χ2=13.785, P=0.001) and dialysis age (χ2=27.939, P＜0.001) of the MHD patients. The incidence of sleep difficulty was also significantly different, relating to age (χ2=9.598, P=0.008) and primary disease (χ2=4.585, P=0.032) of the MHD patients. Conclusions The prevalence of symptoms is high in MHD patients. These symptoms are significant different in prevalence rate, severity, and influences on the patients, and are coexistent and correlated. Therefore, the essential approaches to manage symptoms in MHD patients should include symptom assessment, symptom management by multidisciplinary team, drugs and other interventions, and self-management ability.

Key words: Maintenance hemodialysis, Symptom experience, Quality of life