Endocrinology
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Kidney Awareness Week provides an opportunity to reflect not only on the importance of kidney health but also on the experiences of those living with chronic kidney disease and undergoing dialysis.
At Mediclinic Renal Services, we are deeply committed to enhancing comfort and quality of life for our patients — and that starts with listening. By understanding the real challenges our patients face, including the burden of pain, we are discovering better ways to deliver care that genuinely supports their wellbeing.
Following the recent introduction of a patient-based outcomes survey, Mediclinic Renal Services is pleased with the additional insights and feedback gained from each of our clients' responses regarding their experienced outcomes.
According to Nelda van Soelen, Managing Director Mediclinic Renal Services for Mediclinic Renal Services, one of the earliest trends identified from patient feedback was the frequency and impact of pain during or after dialysis. It has helped the team recognise patterns both by site and patient profile — for example, trends in muscular cramping prompted a closer examination of how certain symptoms may relate to treatment factors. These insights support more personalised care and continuous improvement initiatives.
For renal patients, the most common types of pain may include muscle cramps, headaches, access site pain—especially in patients with AV fistulas or catheters—and general fatigue or body aches, which are often related to inflammation or anaemia.
Profiling patients who may experience pain
It is understood that some patients are more likely to experience pain or related issues. Such profile patients are diabetic patients (due to peripheral neuropathy), elderly patients (due to vascular stiffness and comorbidities), and patients with poorly controlled hypertension or fluid overload tend to report more discomfort. Patients new to dialysis or those with long-standing catheters may also be more vulnerable.
Differentiating between expected symptoms and complications
“Differentiation comes down to clinical vigilance. Expected symptoms like mild fatigue or occasional cramping are monitored over time, but persistent or worsening pain — especially at access sites — triggers clinical review. A sudden change in symptom pattern is also a red flag. Our nursing teams are trained to document, escalate, and investigate when pain deviates from the norm,” Van Soelen explains.
Patients experiencing severe or recurring pain are supported through a clear clinical process. This process involves the dialysis nurse assessing the patient, reporting to the treating nephrologist, and initiating suitable investigations (e.g., access ultrasound, infection screen, or medication review).
Our clinical staff are trained to take all pain reports seriously, not just as symptoms, but as signals of potential underlying issues. They are encouraged to probe gently, ask follow-up questions, and document consistently. We also emphasise the importance of empathy and validating the patient’s experience,” he explains.
Improving Pain Management in Renal Care
Interventions that are most effective in managing post-dialysis pain may include:
- Adjusting dry weights or ultrafiltration rates to reduce cramping
- Applying warm compresses to muscles or access sites
- Fine-tuning the dialysis fluid to balance minerals like calcium and sodium
- Prescribing appropriate pain relief when safe and necessary
Gentle Approaches to Pain Relief
“We promote gentle stretching exercises, optimal patient positioning, hydration counselling, and discussions around dietary balance to prevent excessive fluid or weight gain between dialysis sessions. Patient education also plays a key role in setting realistic expectations and self-management strategies,” he explains.
“This Kidney Awareness Week, Mediclinic Renal Services reaffirms its commitment to truly listening to our renal patients. By using patient insights to better measure outcomes, we are able to tailor care more effectively — qualities that set us apart in renal services.” Van Soelen concludes.