Review article
TREATMENT OF PAIN IN PATIENTS WITH CHRONIC KIDNEY DISEASE
VANJA BAŠIĆ KES
; Sestre milosrdnice University Hospital Centre, Department of Neurology, Ministry of Health Reference Center for Diagnosis and Treatment of Acute and Chronic Pain, Zagreb, University of Zagreb, School of Dental Medicine, Zagreb, Josip Juraj Strossmayer Uni
PETAR KES
; University of Zagreb, School of Medicine and Academy of Medical Sciences of Croatia, Zagreb, Croatia
Abstract
According to the International Association for the Study of Pain defi nition, “pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”. The prevalence of pain has been reported to be more than 60% among patients with acute or chronic kidney disease (CKD) and end-stage kidney disease (ESRD). It is widely recognized that pain, in particular chronic pain, is associated with psychological distress, depressive disorders, limitations in family, work and social life, decreased quality of life, increased hospitalizations and mortality rate. The aim of this article is to help health care professionals assess the impact of renal function on the treatment of pain and provide safe and effective analgesia for patients with impaired renal function. Analgesia is problematic in CKD patients for several reasons. Some drugs may accumulate as they are excreted via kidney, whilst others may have increased toxic effects in patients with renal disease. Drugs with nephrotoxic effects need to be used with particular caution. There is evidence that pain in patients with CKD is undertreated, with signifi cant consequences for patients. Analgesics play an important role in pain management but they should not be the sole focus of treatment. Nonpharmacological therapies that address the whole patient in the context of their personal life and disease are a vital part of managing chronic pain and analgesics should only be used to augment these therapies as required to achieve adequate relief. Unfortunately, there are no studies investigating clinical outcomes of chronic analgesic use in patients with CKD or ESRD. This will clearly need to be changed if we want to optimize effective and safe management of pain in CKD patients.
Keywords
pain; analgesics; management; chronic kidney disease; dialysis
Hrčak ID:
237921
URI
Publication date:
24.4.2020.
Visits: 5.118 *