Nephrology pre-dialysis care affects the psychological adjustment, not only blood pressure, anemia, and phosphorus control

The Effect of Health Literacy on Patient Outcomes in Stage 3b-4 Pre-Dialysis Patients: A Semi-Experimental Study

This study was conducted to investigate the effect of health literacy on patient outcomes in pre-dialysis patients. A semi-experimental study. The study was conducted with 45 intervention and 45 control patients with glomerular filtration rates between 15-44ml/min/1.73m2. The adequate health literacy of the patients in the intervention group increased from 2.2% to 31.1%. Increased health literacy led to a significant decrease in systolic and diastolic blood pressure values and the severity of symptoms. The study showed that increased health literacy in pre-dialysis patients improves patient outcomes. Nursing care is needed in pre-dialysis.

Managing the symptom burden associated with maintenance dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Individuals with kidney failure undergoing maintenance dialysis frequently report a high symptom burden that can interfere with functioning and diminish life satisfaction. Until recently, the focus of nephrology care for dialysis patients has been related primarily to numerical targets for laboratory measures, and outcomes such as cardiovascular disease and mortality. Routine symptom assessment is not universal or standardized in dialysis care. Even when symptoms are identified, treatment options are limited and are initiated infrequently, in part because of a paucity of evidence in the dialysis population and the complexities of medication interactions in kidney failure. In May of 2022, Kidney Disease: Improving Global Outcomes (KDIGO) held a Controversies Conference-Symptom-Based Complications in Dialysis-to identify the optimal means for diagnosing and managing symptom-based complications in patients undergoing maintenance dialysis. Participants included patients, physicians, behavioral therapists, nurses, pharmacists, and clinical researchers. They outlined foundational principles and consensus points related to identifying and addressing symptoms experienced by patients undergoing dialysis and described gaps in the knowledge base and priorities for research. Healthcare delivery and education systems have a responsibility to provide individualized symptom assessment and management. Nephrology teams should take the lead in symptom management, although this does not necessarily mean taking ownership of all aspects of care. Even when options for clinical response are limited, clinicians should focus on acknowledging, prioritizing, and managing symptoms that are most important to individual patients. A recognized factor in the initiation and implementation of improvements in symptom assessment and management is that they will be based on locally existing needs and resources.