C T BACH1, M RP DAVIES1, P F MOUNT1,2
1Department of Nephrology, Austin Health, Heidelberg, Australia, 2Department of Medicine, University of Melbourne, Parkville, Australia
Aim: To evaluate the prevalence and associations of pain in patients with end stage kidney disease (ESKD).
Background: Patients with ESKD can experience a high burden of symptoms, including pain. Pain in ESKD patients is a poorly understood complex symptom affecting patients physically and mentally, resulting in significant impacts on quality of life.
Method: A retrospective study based on patient-completed Patient Outcome Scale-renal (POS-R) questionnaires, completed between 1st June 2018 and 28th February 2020. Patients were defined as having pain if they scored 2 (moderate) or higher for pain. Analysis was performed comparing patients with pain vs no pain.
Results: A total of 190 patients were included, with 67 patients (35%) reporting pain. Patients on satellite-haemodialysis were more likely to report pain than patients on peritoneal dialysis (42.1% vs 12.8%, p<0.009). The median duration of renal replacement therapy for patients in the pain group was 4.83 years compared to 2.42 years (p < 0.0002). Chronic lung disease, coronary artery disease and diabetes were all more prevalent in patients with pain. Patients reporting pain also reported higher scores for other symptoms, including depression, poor mobility and difficulty sleeping (p < 0.001 for each).
Conclusion: Pain is a complex and common symptom in patients with ESKD, found with increasing prevalence with duration of dialysis and comorbidity burden. Presence of pain is associated with higher POS-R scores for depression and poor sleep. Effective pain management strategies are needed to help preserve quality of life in ESKD patients.
Cindy is a general medicine advanced trainee and will commence renal advanced training at Austin Health in 2021.