Opioids for chronic pain management in patients with dialysis-dependent kidney failure.
Opioids for chronic pain management in patients with dialysis-dependent kidney failure.
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DOI：
10.1038/s41581-021-00484-6
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
HOPE Consortium
中科院分区：
文献类型：
--
作者：
Tobin DG;Lockwood MB;Kimmel PL;Dember LM;Eneanya ND;Jhamb M;Nolin TD;Becker WC;Fischer MJ;HOPE Consortium
慢性疼痛在接受维持性血液透析 (HD) 治疗的成年人中非常普遍，并且具有深远的负面影响。四十年来，研究表明，接受 HD 治疗的成年患者中有 50-80% 表示有疼痛。一半 HD 依赖性肾衰竭 (HDKF) 患者患有慢性中度至重度疼痛，这与癌症患者的疼痛负担相似。然而，HDKF 患者的疼痛管理通常无效，因为大多数患者报告他们的疼痛没有得到充分治疗。与患有慢性疼痛的普通人群相比，接受 HD 治疗的患者更频繁地使用阿片类镇痛药，并且与发病率、死亡率和医疗资源使用增加有关。此外，当前的阿片类药物处方模式常常与指南推荐的护理不一致。目前，阿片类药物对于一般疼痛管理（特别是 HDKF 患者）的有效性尚缺乏证据。尽管如此，长期阿片类药物治疗在选择性、谨慎使用并结合持续的风险和获益评估的情况下，对某些患者的治疗具有一定作用。在这里，我们全面概述了阿片类药物治疗 HDKF 和慢性疼痛患者的使用情况，包括讨论丁丙诺啡，由于其独特的药理学特性，丁丙诺啡有潜力成为 HD 患者的镇痛选择。
Chronic pain is highly prevalent among adults treated with maintenance haemodialysis (HD) and has profound negative effects. Over four decades, research has demonstrated that 50–80% of adult patients treated with HD report having pain. Half of patients with HD-dependent kidney failure (HDKF) have chronic moderate-to-severe pain, which is similar to the burden of pain in patients with cancer. However, pain management in patients with HDKF is often ineffective as most patients report that their pain is inadequately treated. Opioid analgesics are prescribed more frequently for patients receiving HD than for individuals in the general population with chronic pain, and are associated with increased morbidity, mortality and health-care resource use. Furthermore, current opioid prescribing patterns are frequently inconsistent with guideline-recommended care. Evidence for the effectiveness of opioids in pain management in general, and in patients with HDKF specifically, is lacking. Nonetheless, long-term opioid therapy has a role in the treatment of some patients when used selectively, carefully and combined with an ongoing assessment of risks and benefits. Here, we provide a comprehensive overview of the use of opioid therapy in patients with HDKF and chronic pain, including a discussion of buprenorphine, which has potential as an analgesic option for patients receiving HD owing to its unique pharmacological properties.
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影响因子：
7.4
作者：
Campbell, CM;Edward, RR;Fillingim, RB
通讯作者：
Fillingim, RB
影响因子：
--
作者：
Braden, Jennifer Brennan;Russo, Joan;Sullivan, Mark D.
通讯作者：
Sullivan, Mark D.
影响因子：
3.6
作者：
Berger, Alexandra Joice;Wang, Ye;Haleblian, George
通讯作者：
Haleblian, George
DOI：
10.1093/pm/pnx285
发表时间：
2018-01-01
期刊：
Pain medicine (Malden, Mass.)
影响因子：
--
作者：
Argoff CE;Alford DP;Fudin J;Adler JA;Bair MJ;Dart RC;Gandolfi R;McCarberg BH;Stanos SP;Gudin JA;Polomano RC;Webster LR
通讯作者：
Webster LR
影响因子：
4
作者：
Agarwal D;Udoji MA;Trescot A
通讯作者：
Trescot A