Optimizing symptom management in people with kidney failure

People with kidney failure experience high symptom burden, which is associated with an increased risk of mortality, morbidity, and impaired quality of life. Symptoms are often severe and persistent, affecting many organs and causing considerable physical, psychological, and emotional distress. The causes of symptoms are often multifactorial, and the underlying pathophysiology is often poorly understood. Managing symptoms is challenging because of uncertainty regarding the use of validated patient-reported outcome measures in clinical practice and limited evidence for interventions to relieve symptoms. Addressing these challenges requires developing and validating symptom-targeted interventions and integrating symptom management strategies within a multidisciplinary framework, including nephrologists, palliative care physicians, and allied health and mental health professionals. This review provides an overview of the epidemiology and adverse impacts of symptoms in people with kidney failure. We will also provide practical guidance on selecting the appropriate symptom measures and evidence-based interventions for symptom assessment and management in kidney failure care.