Original investigation: dialysis therapyPain in hemodialysis patients: prevalence, cause, severity, and management
Section snippets
Patient selection
This is a prospective cohort study of HD patients at the University of Alberta, Canada (2 in-center and 2 satellite HD units). The study was conducted between September 2001 and July 2002. All eligible patients were invited to participate. Eligibility criteria included age older than 18 years and the ability to converse and complete the questionnaires in English. Ethics approval was obtained from the University of Alberta Health Research Ethics Board, and written informed consent was obtained
Patient characteristics and prevalence of pain
There were 215 eligible patients. Two hundred five patients (81.7% response rate) were enrolled, and 46 patients refused participation. Patients refused because they did not wish to complete the questionnaire. Of these 46 patients, 18 patients (39%) were administered analgesics.
Patient characteristics are listed in Table 1. Study patients were mostly Caucasian (78.5%), with an average age of 60.0 ± 15.9 years. Fifty percent (n = 103) of patients reported a problem with pain. The only
Discussion
This study shows that pain is a common problem in HD patients. Fifty percent of HD patients in this study reported a problem with chronic pain, and 55% of these patients rated their pain as severe. Moreover, because 74.8% of patients had negative PMI scores, the study shows that pain management is suboptimal in patients undergoing long-term HD therapy.
The prevalence of chronic pain in the general population ranges from 2% to 45%.28, 29, 30, 31, 32 Variability in prevalence rates may be
Acknowledgements
The author thanks Judy Peng for help with administration of pain questionnaires and Gian Jhangri for statistical support and acknowledges the constructive suggestions provided by 3 anonymous reviewers.
References (63)
Investigating the relationship between pain and discomfort and quality-of-life using the WHOQOL
Pain
(1998)- et al.
Quality-of-life evaluation using the Short-Form 36Comparison in hemodialysis and peritoneal dialysis patients
Am J Kidney Dis
(2000) - et al.
Monitoring dialysis patients’ health status
Am J Kidney Dis
(1994) - et al.
Quality of life over time in dialysisThe Netherlands Cooperative Study on the Adequacy of Dialysis
Kidney Int
(1999) - et al.
Dialysis discontinuation and withdrawal of dialysis
Am J Kidney Dis
(2000) - et al.
Pain, control over treatment, and compliance in dialysis and transplant patients
Kidney Int
(1982) - et al.
Recurrent pain, illness intrusiveness, and quality of life in end-stage renal disease
Pain
(1990) - et al.
Pain measurement tools and methods in clinical research in palliative careRecommendations of an Expert Working Group of the European Association of Palliative Care
J Pain Symptom Manage
(2002) - et al.
Development of the Wisconsin Brief Pain Questionnaire to assess pain in cancer and other diseases
Pain
(1983) - et al.
When is cancer pain mild, moderate or severe? Grading pain severity by its interference with function
Pain
(1995)
Validation of World Health Organization guidelines for cancer pain reliefA 10-year prospective study
Pain
The McGill Pain QuestionnaireMajor properties and scoring methods
Pain
Use of the McGill Pain Questionnaire in the assessment of cancer painReplicability and consistency
Pain
The use of the McGill Pain Questionnaire in assessing arthritis pain
Pain
Pain measurementConstruct validity of the affective dimension of the McGill Pain Questionnaire with chronic benign pain patients
Pain
The epidemiology of chronic pain in the community
Lancet
Prevalence of chronic benign pain disorder among adultsA review of the literature
Pain
Prevalence of pain in general practice
Eur J Pain
Prevalence of pain in the Spanish populationTelephone survey in 5000 homes
Eur J Pain
An epidemiologic comparison of pain complaints
Pain
Chronic pain prevalence and analgesic prescribing in a general medical population
J Pain Symptom Manage
Cancer breakthrough pain characteristics and responses to treatment at a VA medical center
Pain
Dimensions of the impact of cancer pain in a four country sampleNew information from multidimensional scaling
Pain
Prevalence of pain in Italian hospitalsResults of a regional cross-sectional survey
J Pain Symptom Manage
The prevalence of pain in hospitalized patients and resolution over six months
Pain
Emerging concepts in the neurobiology of chronic painEvidence of abnormal sensory processing in fibromyalgia
Mayo Clinic Proc
Painful neuropathyAltered central processing maintained dynamically by peripheral input
Pain
Studies on morphine dispositionInfluence of renal failure on kinetics of morphine and its metabolites
Br J Anaesth
Normorphine, a neurotoxic metabolite?
Lancet
Morphine-6-glucuronide, a potent mu agonist
Life Sci
Chronic nausea and morphine-6-glucuronide
J Pain Symptom Manage
Cited by (316)
The design and baseline characteristics for the HOPE Consortium Trial to reduce pain and opioid use in hemodialysis
2024, Contemporary Clinical TrialsWeighing the pros and cons of opioids in renal patients with protein-energy wasting: the triaging potential of frailty
2023, Clinical Nutrition Open ScienceAcceptability and feasibility of fecal microBIOME and serum metabolite sample collection in people with end-stage kidney disease and pain being treated with HemoDialysis: A pilot study (BIOME-HDp)
2022, Contemporary Clinical Trials CommunicationsDisparities in Mental Health and Well-Being Among Black and Latinx Patients With Kidney Disease
2021, Seminars in Nephrology