Symptom management among patients with chronic kidney diseas
Patients with chronic kidney disease (CKD) experience high symptom burden, both physical and psychological, with low socioeconomic status negatively affecting the experience of symptoms. Recent evidence suggests that symptom burden is not dependent on CKD stage, with patients in all stages experiencing symptoms that could potentially impact their quality of life (QoL). CKD patients have a median of five to six symptoms. Patients with end-stage kidney disease (ESKD) report a median number of 5.7–7.5 symptoms.

Those with Stage 5 CKD have physical and psychological symptom burdens similar or greater than that of advanced cancer patients. Health-care providers frequently underrecognize and undertreat symptoms in CKD. Assessment of symptom burden should be done at the first visit and at every follow-up visit for emergence of new symptoms and to assess the effectiveness of treatment.

Validated global symptom assessment tools are available and are appropriate for routine screening in renal programs, which will aid the identification of common and troublesome symptoms. Some of the commonly used validated tools include the Edmonton Symptom Assessment System (ESAS)-Revised: Renal, Integrated Palliative Care Outcome Scale-Renal (IPOS-Renal), and Dialysis Symptom Index. The use of validated questionnaires will facilitate the assessment of symptoms in a systematic manner and should be incorporated into routine clinical practice to optimize symptom management.