Bring a large pot of water to a boil over high heat. Generously salt the water then add the pasta and cook until al dente according to package instructions. Once done, reserve 1 cup of pasta water then drain the pasta. Meanwhile, make the sauce.
Heat a large Dutch oven over medium-high heat. Add the Italian sausage and cook until browned, breaking it up as it cooks. Once browned, reduce the heat to medium and transfer the meat to a bowl.
Heat the olive oil in the Dutch oven then add the onions. Sauté until translucent, scraping up any brown bits in the pot. Add the fennel seeds and garlic and toss around for about 30 seconds until fragrant.
Add the sausage back to the pot then stir in the crushed tomatoes, salt, pepper, and crushed red pepper. Bring to a simmer.
Reduce to medium-low heat and continue simmering for 5 minutes.
To the sauce, add the cream, pecorino romano, and ½ cup (125 ml) of reserved pasta water. Stir to combine then taste and add more salt if needed.
Toss in the chopped kale, cooking until wilted. Add the pasta to the sauce and gently toss until everything is well coated. If the sauce is too thick, add a splash of pasta water. Keep on low heat while you toast the pine nuts.
Add the pine nuts to a small saucepan and place over medium heat. Move them around occasionally until toasted/browned.
Serve the pasta with a sprinkle of pine nuts and freshly grated pecorino romano.