Pain in Hemodialysis Patients: Prevalence, Intensity, Location, and Functional Interference in Daily Activities.

Patrícia Roberta Dos Santos,Carolina Rodrigues Mendonça,Matias Noll,Naiara Toledo Dias,Cezimar Correia Borges,Amanda Maria De Sousa Romeiro,Celmo Celeno Porto,Polissandro Mortoza Alves,Maria Alves Barbosa

doi:10.3390/healthcare9101375

Abstract

Although pain is a frequent complaint of patients with chronic kidney disease who undergo hemodialysis, few studies have assessed the functional interference of pain in activities of daily living (ADLs). Hence, the aim of this study was to evaluate the prevalence, location, intensity, and functional interference of pain in ADLs of chronic kidney disease patients undergoing hemodialysis and to estimate the association of specific pain sites with severe functional interference by pain in ADLs. This cross-sectional study included patients with chronic kidney disease undergoing hemodialysis. The prevalence, intensity, and functional interference of pain in ADLs were assessed using the brief pain inventory. Poisson regression was used to calculate the prevalence ratio. A total of 65 patients participated in the study. The overall prevalence of pain was 89.23%; the prevalence of headache was 18.46% and that of pain in the trunk was 55.38%, upper limbs was 35.38%, and lower limbs was 60.00%. The prevalence of moderate and severe pain at the time of hemodialysis was 13.85% and 21.54%, respectively. A high prevalence of severe functional interference of pain in general activity (61.54%), mobility (56.92%), and disposition (55.38%) was observed. Pain is a frequent complaint in patients undergoing hemodialysis, mainly musculoskeletal and intradialytic, and it interferes with ADLs and incapacitates the patient. Pain was highly prevalent in the upper and lower limbs and the trunk. Furthermore, a higher prevalence of severe pain at the time of hemodialysis and functional interference of pain, mainly in general activity, mobility, and disposition, were observed.

Highlights

IntroductionChronic kidney disease (CKD) is a public health problem [1] with a global prevalence of 9.1% (697.5 million cases) and is the 12th leading cause of death worldwide [2]
The results of this study indicate that patients with Chronic kidney disease (CKD) show a high prevalence of pain, especially in the upper and lower limbs and the trunk
The results are clinically important, mainly because the high prevalence of pain and the non-use of opioids found in this study reveal the possible failure in adequate pain assessment of patients with CKD and, the possibility of inappropriate and ineffective prescription of medications

Summary

Introduction

Chronic kidney disease (CKD) is a public health problem [1] with a global prevalence of 9.1% (697.5 million cases) and is the 12th leading cause of death worldwide [2]. In. Brazil, the number of patients undergoing dialysis increased from 42,695 in 2000 to 91,314 in 2011 [3], reaching 133,464 in 2018 [4]. Brazil is the third country in the world in the number of patients requiring dialysis in the long term [4]. In CKD, changes in glomerular filtration rates, whether or not associated with parenchymal changes, for more than 3 months [5,6] require treatment via renal replacement therapy by peritoneal dialysis or hemodialysis (HD) for maintaining homeostasis and increasing patient survival [7]

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