Living Well With Kidney Disease and Effective Symptom Management: Consensus Conference Proceedings

Chronic kidney disease (CKD) confers a high burden of uremic symptoms that may be underrecognized,underdiagnosed, and undertreated. Unpleasant symptoms, such as CKD-associated pruritus andemotional/psychological distress, often occur within symptom clusters, and treating 1 symptom maypotentially alleviate other symptoms in that cluster. The Living Well with Kidney Disease and EffectiveSymptom Management Consensus Conference convened health experts and leaders of kidney advocacygroups and kidney networks worldwide to discuss the effects of unpleasant symptoms related to CKD onthe health and well-being of those affected, and to consider strategies for optimal symptom management.Optimizing symptom management is a cornerstone of conservative and preservative management whichaim to prevent or delay dialysis initiation. In persons with kidney dysfunction requiring dialysis (KDRD),incremental transition to dialysis and home dialysis modalities offer personalized approaches. KDRD isproposed as the preferred term given the negative connotations of“failure”as a kidney descriptor, and thesuccess stories in CKD journeys. Engaging persons with CKD to identify and prioritize their personal valuesand individual needs must be central to ensure their active participation in CKD management, includingKDRD. Person-centered communication and care are required to ensure diversity, equity, and inclusion;education/awareness that considers the health literacy of persons with CKD; and shared decision-makingamong the person with CKD, care partners, and providers. By putting the needs of people with CKD,including effective symptom management, at the center of their treatment, CKD can be optimally treated ina way that aligns with their goals.