Non-pharmacological Intervention Approaches for Common Symptoms in Advanced Chronic Kidney Disease Patients on Haemodialysis: Narrative Review

Abstract

Abstract Background: Patients with advanced chronic kidney disease (CKD) experience many bothersome symptoms, affecting their quality of life (QoL). The majority of these patients do not have the opportunity to receive a kidney transplant and need other treatments for these burdensome symptoms to improve their QoL and prognosis. With growing attention to the significance of symptom management in advanced CKD on haemodialysis (HD), the evidence regarding symptoms is increasing. Methods: In this review, we briefly summarise the current evidence of non-pharmacologic interventions to improve symptoms and QoL in patients with advanced CKD, on dialysis. Hence, we focused on symptoms that are commonly experienced by patients, such as pain, fatigue, sleep disturbances, itching, nausea and vomiting, cognitive impairment and anxiety and depression. Results: We noted that research on improving symptom management in CKD is still very limited. In addition to the lack of clinical practice guidelines to address those common symptoms, the evidence to how to incorporate effective symptom intervention approaches into clinical care is also rare. Conclusion: Although improving mortality remains an important area in the kidney community, there is an urgent need to focus on improving symptommanagement to improve QoL in advanced CKD on HD.