This guide, developed as part of the ExPAND project, presents the recommended approach to evaluating pain and the five principles of pain management. It then presents the most troublesome symptoms reported by patients with advanced chronic kidney disease with recommendations for non-pharmacologic and pharmacologic treatment as well as explanatory notes about the treatment.
This guide presents recommendations only. All doses and adjustments for kidney function remain the responsibility of the prescriber. There is not one generally accepted comprehensive source for all symptom management for patients with kidney disease may report. The references for the recommendations in this guide are listed at the end.
The ExPAND Project's resources were funded through a Patient-Centered Outcomes Research Institute® (PCORI®) Award (IHS-2022C2-27678).
When using or referencing these materials, please include the following citation:
Expanding and Promoting Alternative Care and Knowledge in Decision-Making (ExPAND Project), 2025.
ExPAND Guide for Symptom Assessment and Management in Patients with Advanced Chronic Kidney Disease. George Washington University School of Nursing, WVU Medicine.