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Review
. 2017 Apr 3;12(4):687-693.
doi: 10.2215/CJN.01650216. Epub 2017 Feb 1.

Symptom Management of the Patient with CKD: The Role of Dialysis

Valerie Jorge Cabrera  1 , Joni Hansson  1 , Alan S Kliger  2 , Fredric O Finkelstein  1
Affiliations
Review

Symptom Management of the Patient with CKD: The Role of Dialysis

Valerie Jorge Cabrera et al. Clin J Am Soc Nephrol. .

Abstract

As kidney disease progresses, patients often experience a variety of symptoms. A challenge for the nephrologist is to help determine if these symptoms are related to advancing CKD or the effect of various comorbidities and/or medications prescribed. The clinician also must decide the timing of dialysis initiation. The initiation of dialysis can have a variable effect on quality of life measures and the alleviation of uremic signs and symptoms, such as anorexia, fatigue, cognitive impairment, depressive symptoms, pruritus, and sleep disturbances. Thus, the initiation of dialysis should be a shared decision-making process among the patient, the family and the nephrology team; information should be provided, in an ongoing dialogue, to patients and their families concerning the benefits, risks, and effect of dialysis therapies on their lives.

Keywords: Anorexia; Chronic; Cognition Disorders; Decision Making; Fatigue; Humans; Palliative Care; Pruritus; Renal Insufficiency; Sleep Wake Disorders; depression; initiation of dialysis; nephrology; quality of life; renal dialysis; uremic symptoms.

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