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    Understanding and addressing symptoms for those with kidney failure managed conservatively, without dialysis : considerations and models of care

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    Author
    Murphy, Emma
    Murtagh, Fliss E M
    Affiliation
    University Hospitals Coventry and Warwickshire NHS Trust; University of Hull
    Publication date
    2024-06-18
    Subject
    Nephrology/Renal medicine
    
    Metadata
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    Abstract
    For those who have kidney failure and are managed conservatively without dialysis, symptoms are often prevalent, multiple, and troublesome. They interfere with quality of life, reduce wellbeing, and can affect family carers too. Symptoms can sometimes be difficult to manage, and—for professionals—they are often hard to assess and not always amenable to management with medications appropriate for use in kidney failure. Fatigue is one of the most common symptoms; alongside a general overview of symptoms in this population, we include a more detailed discussion of this often-neglected symptom. The solutions to the main symptoms experienced by those with kidney failure managed conservatively without dialysis lie in detailed assessment and monitoring of symptoms, working as a multi-disciplinary team to the maximum to draw on the full range of skills and expertise, and use of non-pharmacological, as well as pharmacological, approaches. Both nephrology and palliative care skills and expertise are important to optimise the recognition, assessment, and management of symptoms. There are few published descriptions of models of conservative kidney management (CKM) or supportive kidney care and there is a lack of evidence to suggest which model is most effective. We therefore consider the evidence on optimal models of CKM and make suggestions for best practice.
    Citation
    Murphy E, Murtagh FEM. Understanding and addressing symptoms for those with kidney failure managed conservatively, without dialysis: considerations and models of care. Ann Palliat Med. 2024 Jul;13(4):991-1001. doi: 10.21037/apm-23-422. Epub 2024 Jun 18. PMID: 38902989.
    Type
    Article
    Handle
    http://hdl.handle.net/20.500.14200/5019
    DOI
    10.21037/apm-23-422
    PMID
    38902989
    Journal
    Annals of Palliative Medicine
    Publisher
    AME Publishing Company
    ae974a485f413a2113503eed53cd6c53
    10.21037/apm-23-422
    Scopus Count
    Collections
    Renal

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