The prevalence of pain among patients with chronic kidney disease using systematic review and meta-analysis
The prevalence of pain among patients with chronic kidney disease using systematic review and meta-analysis
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DOI：
10.1016/j.kint.2021.03.041
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发表时间：
2021-08-19
影响因子：
19.6
通讯作者：
Bell, Samira
中科院分区：
文献类型：
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作者：
Lambourg, Emilie;Colvin, Lesley;Bell, Samira
疼痛是慢性肾脏病 (CKD) 患者常见但往往治疗不足的症状，其患病率比一般人群高得多。本系统评价的目的是综合所有可用的定量证据，以便更好地了解 CKD 患者的疼痛患病率和疼痛类型。截至 2021 年 1 月 15 日，检索了四个数据库和灰色文献。通过多个亚组分析和荟萃回归进行随机效应荟萃分析，以进一步探讨研究间的异质性。使用纽卡斯尔-渥太华量表评估纳入研究的质量，并使用 GRADE 方法确定证据水平。一百一十六项研究报告了 40,678 人的数据。荟萃分析结果显示，疼痛的总体患病率为 60%（95% 置信区间 56-64），慢性疼痛的总体患病率为 48%（42-55），神经性疼痛的总体患病率为 10%（6-15）。肾移植受者的疼痛发生率较低，为 46% (37-56)，而接受透析的患者为 63% (57-68)，非透析 CKD 患者为 63% (55-70)。肌肉骨骼疼痛似乎是接受保守治疗的 CKD 患者中最常见的疼痛症状，占 42% (28-56) 或接受透析的患者占 45% (36-55)，而腹痛在肾移植受者中最常见，占 41% (7-86)。因此，所有 CKD 患者亚组都承受着沉重的疼痛负担。因此，提高对这一问题的认识和认识对于为该领域的政策和服务提供提供信息至关重要。
Pain is a common but often undertreated symptom in patients with chronic kidney disease (CKD) with a much higher prevalence than in the general population. The aim of this systematic review was to synthesize all available quantitative evidence, in order to gain a better understanding of pain prevalence and pain types in patients with CKD. Four databases and the grey literature were searched until 15th January 2021. Random-effect meta-analyses were conducted with multiple subgroup analyses and meta-regressions to further explore the between-study heterogeneity. The quality of studies included was assessed using the Newcastle-Ottawa scale and the level of evidence was determined using the GRADE approach. One hundred sixteen studies reported data on 40,678 individuals. Results from meta-analyses yielded an overall prevalence of 60% (95% confidence interval 56-64) for pain, 48% (42-55) for chronic pain and 10% (6-15) for neuropathic pain. The prevalence of pain was lower among kidney transplant recipients 46% (37-56) compared with patients undergoing dialysis 63% (57-68) and those with nondialysis CKD 63% (55-70). Musculoskeletal pain appeared to be the most common pain symptom among patients with CKD managed conservatively 42% (28-56) or receiving dialysis 45% (36-55) whilst abdominal pain was most prevalent in kidney transplant recipients 41% (7-86). Thus, all subgroups of patients with CKD suffer from a high burden of pain. Hence, greater awareness and recognition of this issue is vital to inform policy and service provision in this area.