Developing consensus-based symptom-management guidance for advanced kidney disease: findings from a national Delphi...

Area of Science:

• Nephrology
• Symptom Management
• Clinical Practice Guidelines

Background:

• Advanced kidney disease (AKD) presents complex symptom management challenges.
• Pharmacological and non-pharmacological interventions are utilized for symptom control.
• A need exists for clear guidance for patients and professionals on prioritizing interventions.

Purpose of the Study:

• To develop consensus-based symptom management guidance for adults with AKD.
• To assist kidney healthcare professionals in identifying and prioritizing interventions.
• To provide a framework for symptom management in nephrology care.

Main Methods:

• A four-round Delphi study involving a national expert panel of adults with AKD and kidney healthcare professionals.
• Anonymous Delphi design to minimize group conformity and ensure independent reassessment.
• Interventions identified through literature search and expert panel suggestions, rated for relevance, importance, and frequency.

Main Results:

• A panel of 54 experts, predominantly with extensive nephrology experience, participated.
• 242 interventions achieved consensus agreement (>70%) after four Delphi rounds.
• Interventions were prioritized based on perceived importance and frequency in nephrology practice.

Conclusions:

• A national consensus-based guidance for symptom management in adults with AKD was successfully developed.
• The guidance integrates evidence, clinical expertise, and patient perspectives.
• This provides a foundation for enhancing symptom management support resources in nephrology.