Post-Dialysis Syndrome: A Narrative Review.

Area of Science:

• Nephrology
• Patient Experience
• Symptom Management

Background:

• Post-dialysis syndrome (PDS) describes debilitating physical, cognitive, psychological, and behavioral symptoms following dialysis sessions.
• The term PDS is recommended to better capture the multidimensional nature and burden of these symptoms, potentially reducing patient stigma.
• PDS pathophysiology is multifactorial, influenced by inflammation, nutrition, and various clinical and psychosocial factors.

Purpose of the Study:

• To synthesize current literature on the characterization, pathophysiology, measurement, and management of post-dialysis syndrome.
• To highlight the need for established guidelines for defining, diagnosing, and managing PDS.
• To review existing measurement tools and potential interventions for PDS.

Main Methods:

• This study is a narrative review of existing and emerging literature on post-dialysis syndrome.
• Literature search focused on characterization, pathophysiology, measurement tools, and interventions for PDS.
• Analysis of quantitative and qualitative data regarding PDS symptom measurement and treatment efficacy.

Main Results:

• Current measurement tools for PDS vary in their ability to capture symptom heterogeneity and psychometric properties.
• Potential interventions like exercise and cognitive behavioral therapy have been studied for specific symptoms, but not comprehensively for PDS.
• There are no established guidelines for the diagnosis and management of PDS, despite patient advocacy for further research.

Conclusions:

• A pragmatic approach to PDS management is recommended, including detailed medical history, patient-reported outcome measures, and shared decision-making.
• Further research is crucial for developing effective diagnostic criteria and management strategies for PDS.
• Addressing PDS requires a comprehensive understanding of its multidimensional impact on dialysis patients.