Is dialysis painful
In our experience, most ESRD patients seek analgesic help from their nephrologist who they may see several times per week compared to a primary care provider who they may see once or twice a year.
Likewise, certified pain clinicians who focus on interventional therapy often feel equally inadequate prescribing medications to this unique population. This has become a catch-22, because neither provider is an expert at pain management. Nephrologists often are forced to address analgesic needs for their patients with ESRD or dialysis because primary care providers often feel uncomfortable prescribing analgesics and other therapies in this specialized population. There are no published clinical practice guidelines addressing medications for chronic pain specifically for patients with ESRD or requiring dialysis. Unfortunately, there is an absence of pain management recommendations for dialysis patients. 3,4 Approximately 75% of patients on dialysis describe their pain management as inadequate, with 55% reporting a severe pain episode during the last 24 hours. 3 Musculoskeletal pain is the most common type of pain reported, but neuropathy and peripheral vascular pain also is quite common. 2 Increased survival for ESRD and dialysis patients requires a paradigm shift in the treatment approach of many difficult but common comorbid disease states that threaten their quality of life, in particular chronic pain.Ī decade ago, it was found that 50% of long-term dialysis patients reported suffering from chronic pain. 2 Mortality rates among patients with ESRD and dialysis peaked in 2001 since then, mortality rates in these patient groups have declined, with the rate among patients undergoing dialysis decreasing to early 1980s numbers. For example, the incidence of chronic kidney disease (CKD) in people ≥65 years old more than doubled from 2000 to 2008, and end-stage renal disease (ESRD) grew by 600% from 1980 to 2009. 1 Treating this growing elderly population presents many challenges. Census report, life expectancy continues to increase, and those 65 years and older appear to be the greatest beneficiaries of this increased life expectancy, with growth in this group predicted to nearly double by 2030.