ArticleBMC nephrology2026
Developing consensus-based symptom-management guidance for advanced kidney disease: findings from a national Delphi study.
Article in BMC nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSeveral pharmacological and non-pharmacological interventions are used to manage physical symptoms in advanced kidney disease (AKD). Adults with AKD and kidney healthcare professionals require guidance in identifying and prioritizing relevant symptom-management interventions. The aim of this study was to develop a consensus-based symptom-management guidance for adults with AKD and kidney healthcare professionals.
methodsA four-round Delphi study was conducted across Denmark to achieve consensus on symptom-management among a national expert panel of adults with AKD and kidney healthcare professionals. A classical anonymous Delphi design was selected to reduce group conformity and allow independent reassessment of responses across iterative rounds. A pragmatic literature search, alongside suggestions from the expert panel, was used to identify potential interventions. Participants rated the relevance, importance, and frequency of intervention through a series of online surveys. Consensus was defined as > 70% agreement.
resultsThe expert panel consisted of 54 participants, the majority of whom had more than 10 years of nephrology experience. Four Delphi rounds were completed, with response rates of 83%, 67%, 63%, and 59% respectively. The literature search identified 216 interventions with varying levels of evidence, and an additional 80 interventions were suggested by the expert panel. Overall, 242 interventions achieved consensus agreement above 70%. In the final Delphi round, interventions were prioritized according to their perceived importance and frequency in nephrology practice.
conclusionsThis study developed a national consensus-based symptom-management guidance for adults with AKD. By integrating available evidence, clinical expertise, and patient perspectives, the study provides a foundation for future development and evaluation of symptom-management support resources in nephrology care.
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