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Symptom Burden in Terminal Renal Failure — SCE Palliative Medicine MCQ

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ModerateNon-Malignant Palliative CareSymptom Burden in Terminal Renal FailureSCE Palliative Medicine

A 72‑year‑old man with end‑stage renal disease managed conservatively (eGFR 6 mL/min/1.73 m²) is developing uraemic symptoms. Which of the following symptom combinations is most commonly encountered in the terminal phase of renal failure and requires proactive palliative management?

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Correct answer: E — Fatigue, nausea, pruritus, restless legs, drowsiness and breathlessness are frequently the most burdensome symptoms

Option E is correct as it captures the multisystem symptom cluster commonly experienced in late-stage renal failure, as described by both NHS patient information and NICE guidance. Distractor A is incorrect: symptoms are present during life, not post-mortem. Distractor B is incorrect: pain may occur, but is not the only or most common symptom. Distractor C is incorrect: pruritus is common, but not isolated. Distractor E is false: uraemia is rarely asymptomatic at this stage.

Reference: NHS.uk ‘Chronic kidney disease – Symptoms’ (2023); NICE NG107 ‘Renal replacement therapy and conservative management’ (2019)