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Published in:

01-09-2018 | Review Article

Assessing and Treating Chronic Pain in Patients with End-Stage Renal Disease

Author: Flaminia Coluzzi

Published in: Drugs | Issue 14/2018

Abstract

Pain is one of the most common symptoms among patients with end-stage renal disease (ESRD), and is often under recognized and not adequately managed in hemodialysis (HD) patients. Barriers to adequate pain management include poor awareness of the problem, insufficient medical education, fears of possible drug-related side effects, and common misconceptions about the inevitability of pain in elderly and HD patients. Caregivers working in HD should be aware of the possible consequences of inadequate pain assessment and management. Common pain syndromes in HD patients include musculoskeletal diseases and metabolic neuropathies, associated with typical intradialytic pain. Evaluating the etiology, nature, and intensity of pain is crucial for choosing the correct analgesic. A mechanism-based approach to pain management may result in a better outcome. Pharmacokinetic considerations on clearance alterations and possible toxicity in patients with ESRD should drive the right analgesic prescription. Comorbidities and polymedications may increase the risk of drug–drug interactions, therefore drug metabolism should be taken into account when selecting analgesic drugs. Automedication is common among HD patients but should be avoided to reduce the risk of hazardous drug administration. Further research is warranted to define the efficacy and safety of analgesic drugs and techniques in the context of patients with ESRD as generalizing information from studies conducted in the general population could be inappropriate and potentially dangerous. A multidisciplinary approach is recommended for the management of complex pain syndromes in frail patients, such as those suffering from ESRD.

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Title: Assessing and Treating Chronic Pain in Patients with End-Stage Renal Disease
Author: Flaminia Coluzzi
Publication date: 01-09-2018
Publisher: Springer International Publishing
Published in: Drugs / Issue 14/2018
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI: https://doi.org/10.1007/s40265-018-0980-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Assessing and Treating Chronic Pain in Patients with End-Stage Renal Disease

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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