engleski

Pain management in patients with chronic kidney disease

Pain is a complex uncomfortable sensation caused by a multitude of etiologic factors. It is divided into many different types, differing by the mechanism of origin and the presence of other subjective sensations related to pain. The phenomenon of pain is a subjective one, with various painful stimuli being described and felt differently among individual patients. Therefore, it is often hard to quantify and accurately measure. However, one thing is for certain, regardless of its etiology, type or place of origin, and it is that pain is a disabling condition affecting an individual’s functional, social and biological status and should therefore be treated promptly and appropriately. Patients with chronic kidney disease (CKD), especially those with end stage renal disease, are often undertreated for pain, resulting in lower adherence to therapy and a higher incidence of anxiety and depression, ultimately leading to an overall lower quality of life. There are many factors included in the undertreatment of pain in this patient population, the main ones being inappropriate pain assessment and fear of prescribing pain medication due to renal function impairment affecting the pharmacokinetics of most commonly used analgesics. This review aims to educate all physicians working with CKD patients and provide an overview of the most commonly used pharmacological pain management strategies and their feasibility in treating this sensitive patient population, therefore hopefully making the current statistics of undertreated pain in CKD less grim than they currently are.

chronic kidney disease ; end stage renal disease ; opioid analgesics ; pain management ; quality of life

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