Symptom Management of the Patient with CKD: The Role of Dialysis.
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.
Department of Medicine, Section of Nephrology, Yale University, New Haven, Connecticut; and.
Valerie Jorge
VJ
Cabrera
Department of Medicine, Section of Nephrology, Yale University, New Haven, Connecticut; and.
Joni
J
Hansson
Yale New Haven Health System-Performance Management, New Haven, Connecticut.
Alan S
AS
Kliger
Department of Medicine, Section of Nephrology, Yale University, New Haven, Connecticut; and.
Fredric O
FO
Finkelstein
D003072:Cognition Disorders / Q000209:etiology / Q000628:therapy; D003863:Depression / Q000209:etiology / Q000628:therapy; D005221:Fatigue / Q000209:etiology / Q000628:therapy; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D044342:Malnutrition / Q000209:etiology / Q000628:therapy; D009422:Nervous System Diseases / Q000209:etiology / Q000628:therapy; D011537:Pruritus / Q000209:etiology / Q000628:therapy; D011788:Quality of Life; D006435:Renal Dialysis; D063189:Symptom Assessment; D014511:Uremia / Q000150:complications* / Q000628:therapy
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