4.6 Article

Living Well With Kidney Disease and Effective Symptom Management: Consensus Conference Proceedings

Journal

KIDNEY INTERNATIONAL REPORTS
Volume 7, Issue 9, Pages 1951-1963

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.ekir.2022.06.015

Keywords

chronic kidney disease; conservative management; person-centered care; quality of life; symptom clusters; unpleasant symptoms

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Chronic kidney disease (CKD) leads to a variety of uremic symptoms that may not be properly recognized, diagnosed, or treated. Optimizing symptom management is crucial for preventing or delaying the need for dialysis. Taking into account the individual needs and priorities of CKD patients, including effective symptom management, is essential for optimal treatment.
Chronic kidney disease (CKD) confers a high burden of uremic symptoms that may be underrecognized, underdiagnosed, and undertreated. Unpleasant symptoms, such as CKD-associated pruritus and emotional/psychological distress, often occur within symptom clusters, and treating 1 symptom may potentially alleviate other symptoms in that cluster. The Living Well with Kidney Disease and Effective Symptom Management Consensus Conference convened health experts and leaders of kidney advocacy groups and kidney networks worldwide to discuss the effects of unpleasant symptoms related to CKD on the health and well-being of those affected, and to consider strategies for optimal symptom management. Optimizing symptom management is a cornerstone of conservative and preservative management which aim to prevent or delay dialysis initiation. In persons with kidney dysfunction requiring dialysis (KDRD), incremental transition to dialysis and home dialysis modalities offer personalized approaches. KDRD is proposed as the preferred term given the negative connotations of failure as a kidney descriptor, and the success stories in CKD journeys. Engaging persons with CKD to identify and prioritize their personal values and individual needs must be central to ensure their active participation in CKD management, including KDRD. Person-centered communication and care are required to ensure diversity, equity, and inclusion; education/awareness that considers the health literacy of persons with CKD; and shared decision-making among the person with CKD, care partners, and providers. By putting the needs of people with CKD, including effective symptom management, at the center of their treatment, CKD can be optimally treated in a way that aligns with their goals.

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