Abstract
Background and objectives: Chronic musculoskeletal (MS) pain is common in chronic kidney disease (CKD) patients. The association of chronic MS pain and CKD progression has not yet been established.Method: We conducted a prospective cohort study to evaluate the association of chronic MS pain and CKD progression of pre-dialysis CKD patients.Result: A total of 53.2% of pre-dialysis CKD patients had chronic MS pain. Patients classified as progression and non-progression had a similar prevalence of chronic MS pain at baseline, and similar baseline use of NSAIDs and Chinese herbal medicines. Univariate Cox analysis indicated that chronic MS pain and baseline NSAID or Chinese herbal medicine use were not significantly associated with progression of CKD. But multivariate Cox regression found chronic MS pain was independently significantly associated with all-cause mortality (HR, 2.912, 95% CI, 1.004–8.444; p = .049). However, serum levels of hs-CRP were similar between those chronic MS pain patients and without chronic MS pain patients (4.96 ± 9.4 vs. 4.25 ± 13.3 mg/L, p = .535).Conclusion: The CKD patients with chronic MS pain was independently and significantly associated with all-cause mortality, but not independently and significantly associated with CKD progression and composite endpoints. The inflammatory marker-hs-CRP was similar between CKD patients with and without chronic MS pain.
Highlights
The incidence of chronic kidney disease (CKD) is still increasing worldwide despite integrative care and timely referral [1]
Factors associated with primary and composite endpoints by univariate Cox regression In the univariate Cox regression, those patients with comorbidity of diabetes (HR, 6.155; 95% CI, 3.819–9.921; p < .001), hypertension (HR, 2.541; 95% CI, 1.466–4.406; p 1⁄4 .001), lower estimated glomerular filtration rate (eGFR) (HR, 0.965; 95% CI, 0.955–0.975; p < .001), low serum levels of hemoglobin (HR, 0.845; 95% CI, 0.744–0.960; p 1⁄4 .010), low serum levels of
The results indicated that the presence of chronic MS pain was not independently significantly associated with renal progression (HR, 1.428, 95% CI, 0.795–2.564; p 1⁄4 .233) and composite endpoints (HR, 0.917, 95% CI, 0.878–6.161; p 1⁄4 .089) (Table 4)
Summary
The incidence of chronic kidney disease (CKD) is still increasing worldwide despite integrative care and timely referral [1]. Patients with CKD often suffer from chronic pain [3,4]. The possible cause of common chronic MS pain in CKD patients is multifactor. Chronic musculoskeletal (MS) pain is common in chronic kidney disease (CKD) patients. The association of chronic MS pain and CKD progression has not yet been established. Method: We conducted a prospective cohort study to evaluate the association of chronic MS pain and CKD progression of pre-dialysis CKD patients. Univariate Cox analysis indicated that chronic MS pain and baseline NSAID or Chinese herbal medicine use were not significantly associated with progression of CKD. Conclusion: The CKD patients with chronic MS pain was independently and significantly associated with all-cause mortality, but not independently and significantly associated with CKD progression and composite endpoints. The inflammatory marker-hs-CRP was similar between CKD patients with and without chronic MS pain
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