When ESKD complicates the management of pain.
Manisha JhambLaura TuckerJane LiebschutzPublished in: Seminars in dialysis (2020)
Pain is one of the most common symptoms reported by patients with end-stage kidney disease (ESKD) and negatively impacts their health-related quality of life (HRQOL), dialysis adherence, healthcare utilization, and mortality. There are a number of patient-related and health system-related barriers that make it very challenging to treat pain in these patients. Moreover, the limited availability of efficacious and safe nonopiate analgesic options has led to over-use of opioids in this population. We propose a framework for pain assessment and tailored treatment using nonpharmacological and pharmacological approaches to optimize pain management and opioid use. Additionally, we recommend system-level changes to improve care coordination and pain management in ESKD patients.
Keyphrases
- pain management
- chronic pain
- end stage renal disease
- healthcare
- chronic kidney disease
- newly diagnosed
- peritoneal dialysis
- ejection fraction
- neuropathic pain
- prognostic factors
- patient reported outcomes
- cardiovascular events
- spinal cord injury
- type diabetes
- risk factors
- case report
- depressive symptoms
- spinal cord
- palliative care
- physical activity
- combination therapy
- smoking cessation
- patient reported
- skeletal muscle
- sleep quality