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                <term xml:lang="en">quality of life</term>
                <term xml:lang="en">symptoms</term>
                <term xml:lang="en">CKD</term>
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              <p>BACKGROUND AND OBJECTIVES: 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. DESIGN, SETTING, PARTICIPANTS, &amp; MEASUREMENTS: Among 2787 participants (66% men) with eGFR &lt;60 ml/min per 1.73 m(2) 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. RESULTS: Patient mean age (±SD) at baseline was 67±13 years, and mean eGFR was 33±13 ml/min per 1.73 m(2). 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. CONCLUSIONS: 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.</p>
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          <idno type="ISNI">0000 0001 0789 1385</idno>
          <idno type="ROR">https://ror.org/01gyxrk03</idno>
          <orgName>Université de Picardie Jules Verne</orgName>
          <orgName type="acronym">UPJV</orgName>
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            <address>
              <addrLine>Chemin du Thil - 80000 Amiens</addrLine>
              <country key="FR"/>
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            <ref type="url">https://www.u-picardie.fr/</ref>
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        <org type="institution" xml:id="struct-300535" status="VALID">
          <orgName>CHU Amiens-Picardie</orgName>
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            <address>
              <country key="FR"/>
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        <org type="institution" xml:id="struct-300153" status="VALID">
          <idno type="ROR">https://ror.org/05n7yzd13</idno>
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              <addrLine>12 Avenue Paul Vaillant Couturier, 94800 Villejuif</addrLine>
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        <org type="regroupinstitution" xml:id="struct-1066727" status="VALID">
          <orgName>AP-HP. Université Paris Saclay</orgName>
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        <org type="institution" xml:id="struct-303515" status="VALID">
          <orgName>Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]</orgName>
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            <ref type="url">http://www.reseau-chu.org/article/le-nouvel-institut-lorrain-du-coeur-et-des-vaisseaux-louis-mathieu/</ref>
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        <org type="institution" xml:id="struct-300247" status="VALID">
          <orgName>Cancéropôle du Grand Est</orgName>
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            <address>
              <addrLine>Hôpital Hautepierre 1 avenue Molière 67098 Strasbourg Cedex</addrLine>
              <country key="FR"/>
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        <org type="regrouplaboratory" xml:id="struct-254924" status="VALID">
          <orgName>Centre d'investigation clinique de Nancy</orgName>
          <orgName type="acronym">CIC 1433</orgName>
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            <address>
              <addrLine>4 rue du Morvan - Bâtiment Louis Mathieu - 54500 Vandoeuvre-les-Nancy Cedex</addrLine>
              <country key="FR"/>
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            <relation active="#struct-413289" type="direct"/>
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      </listOrg>
      <listOrg type="projects">
        <org type="anrProject" xml:id="projanr-37712" status="VALID">
          <idno type="anr">ANR-10-COHO-0001</idno>
          <idno type="program">Cohortes</idno>
          <orgName>CKD-REIN</orgName>
          <desc>Maladie Rénale Chronique - Réseau Epidémiologie et Information en Néphrologie</desc>
          <date type="start">2010</date>
        </org>
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