TY - JOUR
T1 - Managing the symptom burden associated with maintenance dialysis
T2 - conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference
AU - Mehrotra, Rajnish
AU - Davison, Sara N.
AU - Farrington, Ken
AU - Flythe, Jennifer E.
AU - Foo, Marjorie
AU - Madero, Magdalena
AU - Morton, Rachael L.
AU - Tsukamoto, Yusuke
AU - Unruh, Mark L.
AU - Cheung, Michael
AU - Jadoul, Michel
AU - Winkelmayer, Wolfgang C.
AU - Brown, Edwina A.
AU - Conference Participants
AU - Bagasha, Peace
AU - Bargman, Joanne M.
AU - Bavanandan, Sunita
AU - Beckwith, Hannah
AU - Bennett, Paul N.
AU - Bohm, Clara
AU - Brennan, Frank
AU - Burton, James O.
AU - Cavanaugh, Kerri L.
AU - Chilcot, Joseph
AU - Choi, Peter
AU - Cukor, Daniel
AU - Dember, Laura M.
AU - Dong, Jie
AU - Edwards, Dawn
AU - Erickson, Kevin F.
AU - Figueiredo, Ana
AU - Finkelstein, Fredric O.
AU - Fukagawa, Masafumi
AU - Germain, Michael
AU - Guillano, Franklin B.
AU - Hurst, Helen
AU - Iseki, Kunitoshi
AU - Jardine, Meg J.
AU - Jauré, Allison
AU - Jha, Vivekanand
AU - Jhamb, Manisha
AU - Kanjanabuch, Talerngsak
AU - Lerma, Edgar
AU - Kam-Tao Li, Philip
AU - Liew, Adrian
AU - Małyszko, Jolanta
AU - Proenca de Moraes, Thyago
AU - Moranne, Olivier
AU - Nam Ng, Marques Shek
AU - Ostermann, Marlies
AU - Vervloet, Marc
N1 - Funding Information: The conference was sponsored by KDIGO and was in part supported by unrestricted educational grants from Akebia Therapeutics, Cara Therapeutics, CareDX, CVS Kidney Care, Kaneka, and Vifor Fresenius Medical Care Renal Pharma . The authors thank Jennifer King, PhD, for assistance with manuscript preparation. Publisher Copyright: © 2023 Kidney Disease: Improving Global Outcomes (KDIGO)
PY - 2023/9
Y1 - 2023/9
N2 - Individuals with kidney failure undergoing maintenance dialysis frequently report a high symptom burden that can interfere with functioning and diminish life satisfaction. Until recently, the focus of nephrology care for dialysis patients has been related primarily to numerical targets for laboratory measures, and outcomes such as cardiovascular disease and mortality. Routine symptom assessment is not universal or standardized in dialysis care. Even when symptoms are identified, treatment options are limited and are initiated infrequently, in part because of a paucity of evidence in the dialysis population and the complexities of medication interactions in kidney failure. In May of 2022, Kidney Disease: Improving Global Outcomes (KDIGO) held a Controversies Conference—Symptom-Based Complications in Dialysis—to identify the optimal means for diagnosing and managing symptom-based complications in patients undergoing maintenance dialysis. Participants included patients, physicians, behavioral therapists, nurses, pharmacists, and clinical researchers. They outlined foundational principles and consensus points related to identifying and addressing symptoms experienced by patients undergoing dialysis and described gaps in the knowledge base and priorities for research. Healthcare delivery and education systems have a responsibility to provide individualized symptom assessment and management. Nephrology teams should take the lead in symptom management, although this does not necessarily mean taking ownership of all aspects of care. Even when options for clinical response are limited, clinicians should focus on acknowledging, prioritizing, and managing symptoms that are most important to individual patients. A recognized factor in the initiation and implementation of improvements in symptom assessment and management is that they will be based on locally existing needs and resources.
AB - Individuals with kidney failure undergoing maintenance dialysis frequently report a high symptom burden that can interfere with functioning and diminish life satisfaction. Until recently, the focus of nephrology care for dialysis patients has been related primarily to numerical targets for laboratory measures, and outcomes such as cardiovascular disease and mortality. Routine symptom assessment is not universal or standardized in dialysis care. Even when symptoms are identified, treatment options are limited and are initiated infrequently, in part because of a paucity of evidence in the dialysis population and the complexities of medication interactions in kidney failure. In May of 2022, Kidney Disease: Improving Global Outcomes (KDIGO) held a Controversies Conference—Symptom-Based Complications in Dialysis—to identify the optimal means for diagnosing and managing symptom-based complications in patients undergoing maintenance dialysis. Participants included patients, physicians, behavioral therapists, nurses, pharmacists, and clinical researchers. They outlined foundational principles and consensus points related to identifying and addressing symptoms experienced by patients undergoing dialysis and described gaps in the knowledge base and priorities for research. Healthcare delivery and education systems have a responsibility to provide individualized symptom assessment and management. Nephrology teams should take the lead in symptom management, although this does not necessarily mean taking ownership of all aspects of care. Even when options for clinical response are limited, clinicians should focus on acknowledging, prioritizing, and managing symptoms that are most important to individual patients. A recognized factor in the initiation and implementation of improvements in symptom assessment and management is that they will be based on locally existing needs and resources.
KW - health-related quality of life
KW - hemodialysis
KW - kidney failure
KW - patient-reported outcome measures
KW - peritoneal dialysis
KW - symptoms
UR - http://www.scopus.com/inward/record.url?scp=85165640145&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.kint.2023.05.019
DO - https://doi.org/10.1016/j.kint.2023.05.019
M3 - Article
C2 - 37290600
SN - 0085-2538
VL - 104
SP - 441
EP - 454
JO - Kidney International
JF - Kidney International
IS - 3
ER -