Patients with ESKD, with or without RRT, are heavily burdened with symptoms which may interact and compound each other. The burden of symptoms experienced by patients on dialysis is rarely mentioned in patient information sheets despite being well documented in research data. There are significant barriers to medication use in ESKD including a lack of knowledge of pharmacokinetics in dialysis and conflicting information about drug dose and safety. There is a growing body of literature on the symptom management of patients with ESKD Patients need clear information about the potential effects dialysis and non-dialysis pathways on symptom burden and how this can change with time Standardisation of tools used to collate information about symptoms can assist in the provision of information to patients. We recommend the POS-S (Renal) tool (accessible via the kcl.ac.uk website) for assessing symptom burden.
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