Patients with chronic kidney disease often experience unpleasant symptoms

Gastrointestinal symptoms: constipation, nausea, vomiting, and diarrhea

Neurological symptoms: lightheadedness, headache, and numbness

Cardiopulmonary: shortness of breath, edema 

Dermatological symptoms: pruritus and dry skin 

Painful symptoms: muscle cramps, chest pain, and abdominal pain

Others: sexual dysfunction, sleep disorders, fatigue

The challenges in management

• Symptoms frequently occur in clusters, one being the lead while others follow as secondary symptoms.
• Uremic toxins are usually the main cause of CKD-associated symptoms.
• Treatment by dialysis frequently fails to resolve them and may accumulate additional symptoms.
• Comorbidities further exacerbate symptoms

Approach to treatment

Patient should feel actively supported in their symptom management 

Identification and  targeting of unpleasant symptoms

Tailored palliative care approach

Reference: Kalantar-Zadeh K, Lockwood MB, Rhee CM, et al. Patient-centred approaches for the management of unpleasant symptoms in kidney disease. Nature Reviews Physiology. 2022; DOI: 10.1038/s41581-021-00518-z