Abstract
BackgroundChronic kidney disease (CKD) is a rising medical concern around the world. End-stage kidney disease (ESKD) is the last stage of CKD stages that necessitates renal replacement therapy (RRT), such as hemodialysis (HD), which seems to be the most commonly used type. However, patients on HD still suffer from high mortality and morbidity rates compared to those who receive a kidney transplant. Therefore, we aimed in this study to assess the prevalence of pain among ESKD patients on HD, as well as to explore the factors that were associated with this complaint.MethodsWe conducted a multicenter cross-sectional study in the West Bank, Palestine, between August and November 2018. We used questionnaire-based direct interviews with subjects. After reviewing previous studies in the field, we developed our questionnaire and included items on patients’ social, demographic, and clinical characteristics, including dialysis-related data. It also contained the Brief Pain Inventory (BPI) to assess different aspects of pain symptoms. A convenience sampling technique was used to collect data.ResultsOf the 300 participants, 66.3 % reported having chronic pain. HD sessions themselves were the most commonly cited cause for pain (21.6 %). The most commonly cited site of pain was the upper and lower limbs (37.3 %). Paracetamol was the most frequently used pharmacotherapy for pain alleviation. Multiple regression analysis showed that BMI (p = 0.018), gender (p = 0.023), and the number of comorbidities (p < 0.001) were independently associated with pain severity score.ConclusionsPain is a highly prevalent symptom among HD patients in Palestine. Subpopulations with higher pain severity include females, patients with higher BMI, and those with multiple comorbidities. Healthcare providers should routinely assess pain in HD patients as it is considered a significant concern. This would involve pain assessment and development of a treatment plan to improve clinical outcomes. The nephrology associations should also push for pain management in HD patients as a clinical and research priority to improve pain-related disability.
Highlights
Chronic kidney disease (CKD) is a rising medical concern around the world
End-stage kidney disease (ESKD) is considered the last stage of chronic kidney disease (CKD) that needs renal replacement therapy (RRT) in the form of renal transplantation, peritoneal dialysis, or hemodialysis (HD) [1, 2]
We aimed to explore the epidemiology of pain among ESKD patients on HD and explore variables that might be correlated with chronic pain and the different therapies used to treat this problem
Summary
End-stage kidney disease (ESKD) is the last stage of CKD stages that necessitates renal replacement therapy (RRT), such as hemodialysis (HD), which seems to be the most commonly used type. End-stage kidney disease (ESKD) is associated with increased morbidity and mortality over the world. ESKD is considered the last stage of chronic kidney disease (CKD) that needs renal replacement therapy (RRT) in the form of renal transplantation, peritoneal dialysis, or hemodialysis (HD) [1, 2]. Based on information on 120 countries that have dialysis programs, about almost two million people were on renal replacement therapy by the end of 2005 [3], with 1, 297,000 (68 %) of them receiving HD. In Palestine, the overall number of people with HD in the West Bank in 2016 was 1119 patients [4]. ESKD can result in kidney failure, cardiovascular disease, and even premature death [1]
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