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Assessing and Treating Chronic Pain in Patients with End-Stage Renal Disease

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Abstract

Pain is one of the most common symptoms among patients with end-stage renal disease (ESRD), and is often under recognized and not adequately managed in hemodialysis (HD) patients. Barriers to adequate pain management include poor awareness of the problem, insufficient medical education, fears of possible drug-related side effects, and common misconceptions about the inevitability of pain in elderly and HD patients. Caregivers working in HD should be aware of the possible consequences of inadequate pain assessment and management. Common pain syndromes in HD patients include musculoskeletal diseases and metabolic neuropathies, associated with typical intradialytic pain. Evaluating the etiology, nature, and intensity of pain is crucial for choosing the correct analgesic. A mechanism-based approach to pain management may result in a better outcome. Pharmacokinetic considerations on clearance alterations and possible toxicity in patients with ESRD should drive the right analgesic prescription. Comorbidities and polymedications may increase the risk of drug–drug interactions, therefore drug metabolism should be taken into account when selecting analgesic drugs. Automedication is common among HD patients but should be avoided to reduce the risk of hazardous drug administration. Further research is warranted to define the efficacy and safety of analgesic drugs and techniques in the context of patients with ESRD as generalizing information from studies conducted in the general population could be inappropriate and potentially dangerous. A multidisciplinary approach is recommended for the management of complex pain syndromes in frail patients, such as those suffering from ESRD.

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References

  1. Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS, et al. Global prevalence of chronic kidney disease—a systematic review and meta-analysis. PLoS One. 2016;11(7):e0158765.

    PubMed  PubMed Central  Google Scholar 

  2. Davison SN. Pain in hemodialysis patients: prevalence, cause, severity, and management. Am J Kidney Dis. 2003;42:1239–47.

    PubMed  Google Scholar 

  3. Douglas CA. Palliative care for patients with advanced chronic kidney disease. J R Coll Physicians Edinb. 2014;44:224–31.

    CAS  PubMed  Google Scholar 

  4. Murtagh FE, Addington-Hall J, Higginson IJ. The prevalence of symptoms in end-stage renal disease: a systematic review. Adv Chronic Kidney Dis. 2007;14:82–99.

    PubMed  Google Scholar 

  5. Calls J, Rodriguez Calero MA, Hernandez Sanchez D, Gutierrez Navarro MJ, Juan Amer F, Tura DD, et al. An evaluation of pain in haemodialysis patients using different validated measurement scales. Nefrologia. 2009;29:236–43.

    CAS  PubMed  Google Scholar 

  6. Davison SN, Koncicki H, Brennan F. Pain in chronic kidney disease: a scoping review. Semin Dial. 2014;27:188–204.

    PubMed  Google Scholar 

  7. Brkovic T, Burilovic E, Puljak L. Prevalence and severity of pain in adult end-stage renal disease patients on chronic intermittent hemodialysis: a systematic review. Patient Prefer Adherence. 2016;10:1131–50.

    PubMed  PubMed Central  Google Scholar 

  8. Brkovic T, Burilovic E, Puljak L. Risk factors associated with pain on chronic intermittent hemodialysis: a systematic review. Pain Pract. 2018;18:247–68.

    PubMed  Google Scholar 

  9. Hsu HJ, Yen CH, Hsu KH, Wu IW, Lee CC, Hung MJ, et al. Factors associated with chronic musculoskeletal pain in patients with chronic kidney disease. BMC Nephrol. 2014;15:6.

    PubMed  PubMed Central  Google Scholar 

  10. Davison SN, Jhangri GS. Impact of pain and symptom burden on the health-related quality of life of hemodialysis patients. J Pain Symptom Manag. 2010;39:477–85.

    Google Scholar 

  11. Weisbord SD, Mor MK, Sevick MA, Shields AM, Rollman BL, Palevsky PM, et al. Associations of depressive symptoms and pain with dialysis adherence, health resource utilization, and mortality in patients receiving chronic hemodialysis. Clin J Am Soc Nephrol. 2014;9:1594–602.

    PubMed  PubMed Central  Google Scholar 

  12. Coluzzi F, Mattia C. Mechanism-based treatment in chronic neuropathic pain: the role of antidepressants. Curr Pharm Des. 2005;11:2945–60.

    CAS  PubMed  Google Scholar 

  13. Coluzzi F, Fornasari D, Pergolizzi J, Romualdi P. From acute to chronic pain: tapentadol in the progressive stages of this disease entity. Eur Rev Med Pharmacol Sci. 2017;21:1672–83.

    CAS  PubMed  Google Scholar 

  14. Müller-Schwefe G, Morlion B, Ahlbeck K, Alon E, Coaccioli S, Coluzzi F, et al. Treatment for chronic low back pain: the focus should change to multimodal management that reflects the underlying pain mechanisms. Curr Med Res Opin. 2017;33:1199–210.

    PubMed  Google Scholar 

  15. Arendt-Nielsen L, Morlion B, Perrot S, Dahan A, Dickenson A, Kress HG, et al. Assessment and manifestation of central sensitisation across different chronic pain conditions. Eur J Pain. 2018;22:216–41.

    CAS  PubMed  Google Scholar 

  16. Kress HG, Ahlbeck K, Aldington D, Alon E, Coaccioli S, Coluzzi F, et al. Managing chronic pain in elderly patients requires a CHANGE of approach. Curr Med Res Opin. 2014;30:1153–64.

    CAS  PubMed  Google Scholar 

  17. Tellman MW, Bahler CD, Shumate AM, Bacallao RL, Sundaram CP. Management of pain in autosomal dominant polycystic kidney disease and anatomy of renal innervation. J Urol. 2015;193:1470–8.

    PubMed  Google Scholar 

  18. Scarpioni R, Ricardi M, Albertazzi V, De Amicis S, Rastelli F, Zerbini L. Dialysis-related amyloidosis: challenges and solutions. Int J Nephrol Renovasc Dis. 2016;9:319–28.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Nigwekar SU, Kroshinsky D, Nazarian RM, Goverman J, Malhotra R, Jackson VA, et al. Calciphylaxis: risk factors, diagnosis, and treatment. Am J Kidney Dis. 2015;66:133–46.

    PubMed  PubMed Central  Google Scholar 

  20. Liu JT, Su CH, Chen SY, Liew SJ, Chang CS. Spinal Cord Stimulation improves the microvascular perfusion insufficiency caused by critical limb ischemia. Neuromodulation. 2018;21:489–94.

    PubMed  Google Scholar 

  21. Koncicki HM, Brennan F, Vinen K, Davison SN. An approach to pain management in end stage renal disease: considerations for general management and intradialytic symptoms. Semin Dial. 2015;28:384–91.

    PubMed  Google Scholar 

  22. Wali SO, Alkhouli AF. Restless legs syndrome among Saudi end-stage renal disease patients on hemodialysis. Saudi Med J. 2015;36:204–10.

    PubMed  PubMed Central  Google Scholar 

  23. Bliwise DL, Zhang RH, Kutner NG. Medications associated with restless legs syndrome: a case control study in the US renal data system (USRDS). Sleep Med. 2014;15:1241–5.

    PubMed  PubMed Central  Google Scholar 

  24. Arnold R, Kwai NC, Krishnan AV. Mechanisms of axonal dysfunction in diabetic and uraemic neuropathies. Clin Neurophysiol. 2013;124:2079–90.

    PubMed  Google Scholar 

  25. Kaminski MR, Raspovic A, McMahon LP, Strippoli GF, Palmer SC, Ruospo M, et al. Risk factors for foot ulceration and lower extremity amputation in adults with end-stage renal disease on dialysis: a systematic review and meta-analysis. Nephrol Dial Transplant. 2015;30:1747–66.

    PubMed  Google Scholar 

  26. Yong TY, Khow KSF. Diabetic muscle infarction in end-stage renal disease: a scoping review on epidemiology, diagnosis and treatment. World J Nephrol. 2018;7:58–64.

    PubMed  PubMed Central  Google Scholar 

  27. Aitken E, McLellan A, Glen J, Serpell M, Mactier R, Clancy M. Pain resulting from arteriovenous fistulae: prevalence and impact. Clin Nephrol. 2013;80:328–33.

    PubMed  Google Scholar 

  28. Göksan B, Karaali-Savrun F, Ertan S, Savrun M. Hemodialysis- related headache. Cephalagia. 2004;24:284–7.

    Google Scholar 

  29. Ballinger AE, Palmer SC, Wiggins KJ, Craig JC, Johnson DW, Cross NB, et al. Treatment for peritoneal dialysis-associated peritonitis. Cochrane Database Syst Rev. 2014;(4):CD005284.

  30. Soyupek F, Demir M, Süslü FE, Baykal B, Sezer MT, Yesildag A. The upper extremity musculoskeletal complications in dialysis patients: comparison between hemodialysis and peritoneal dialysis. J Back Musculoskelet Rehabil. 2013;26:267–371.

    PubMed  Google Scholar 

  31. Benz RL, Siegfried JW, Teehan BP. Carpal tunnel syndrome in dialysis patients: comparison between continuous ambulatory peritoneal dialysis and hemodialysis populations. Am J Kidney Dis. 1988;11:473–6.

    CAS  PubMed  Google Scholar 

  32. Stojimirovic B, Milinkovic M, Zidverc-Trajkovic J, Trbojevic-Stankovic J, Maric I, Milic M, et al. Dialysis headache in patients undergoing peritoneal dialysis and hemodialysis. Ren Fail. 2015;37:241–4.

    CAS  PubMed  Google Scholar 

  33. Dong R, Guo ZY, Ding JR, Zhou YY, Wu H. Gastrointestinal symptoms: a comparison between patients undergoing peritoneal dialysis and hemodialysis. World J Gastroenterol. 2014;20:11370–5.

    PubMed  PubMed Central  Google Scholar 

  34. Juergensen E, Wuerth D, Finkelstein SH, Juergensen PH, Bekui A, Finkelstein FO. Hemodialysis and peritoneal dialysis: patients’ assessment of their satisfaction with therapy and the impact of the therapy on their lives. Clin J Am Soc Nephrol. 2006;1:1191–6.

    PubMed  Google Scholar 

  35. Morlion B, Coluzzi F, Aldington D, Kocot-Kepska M, Pergolizzi J, Mangas AC, et al. Pain chronification: what should a non-pain medicine specialist know? Curr Med Res Opin. 2018;34:1169–78.

    PubMed  Google Scholar 

  36. Haefeli M, Elfering A. Pain assessment. Eur Spine J. 2006;15(Suppl 1):S17–24.

    PubMed  Google Scholar 

  37. Melzack R. The McGill pain questionnaire: major properties and scoring methods. Pain. 1975;1:277–99.

    CAS  PubMed  Google Scholar 

  38. Daut RL, Cleeland CS, Flanery RC. Development of the Wisconsin Brief Pain Questionnaire to assess pain in cancer and other diseases. Pain. 1983;17:197–210.

    CAS  PubMed  Google Scholar 

  39. Bennett MI, Smith BH, Torrance N, Potter J. The S-LANSS score for identifying pain of predominantly neuropathic origin: validation for use in clinical and postal research. J Pain. 2005;6:149–58.

    PubMed  Google Scholar 

  40. Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain. 2005;114:29–36.

    PubMed  Google Scholar 

  41. Freynhagen R, Baron R, Gockel U, Tölle TR. painDETECT: a new screening questionnaire to identify neuropathic compo- nents in patients with back pain. Curr Med Res Opin. 2006;22:1911–20.

    PubMed  Google Scholar 

  42. Jensen MP, Dworkin RH, Gammaitoni AR, Olaleye DO, Oleka N, Galer BS. Assessment of pain quality in chronic neuropathic and nociceptive pain clinical trials with the Neuropathic Pain Scale. J Pain. 2005;6:98–106.

    PubMed  Google Scholar 

  43. Coluzzi F, Puleo L, Di Bussolo E, Muci ML, Mazzaferro S. Pain management in patients with end-stage renal disease undergoing hemodialysis. Abstract EFIC7-0943;10th Congress of the European Pain Federation, EFIC® 2017, Copenhagen, Denmark

  44. Preljevic VT, Østhus TB, Sandvik L, Opjordsmoen S, Nordhus IH, Os I, et al. Screening for anxiety and depression in dialysis patients: comparison of the Hospital Anxiety and Depression Scale and the Beck Depression Inventory. J Psychosom Res. 2012;73:139–44.

    PubMed  Google Scholar 

  45. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13.

    CAS  PubMed  PubMed Central  Google Scholar 

  46. Kusztal M, Trafidło E, Madziarska K, Augustyniak-Bartosik H, Karczewski M, Weyde W, et al. Depressive symptoms but not chronic pain have an impact on the survival of patients undergoing maintenance hemodialysis. Arch Med Sci. 2018;14:265–75.

    PubMed  Google Scholar 

  47. Khatib ST, Hemadneh MK, Hasan SA, Khazneh E, Zyoud SH. Quality of life in hemodialysis diabetic patients: a multicenter cross-sectional study from Palestine. BMC Nephrol. 2018;19:49.

    PubMed  PubMed Central  Google Scholar 

  48. Zyoud SH, Daraghmeh DN, Mezyed DO, Khdeir RL, Sawafta MN, Ayaseh NA, et al. Factors affecting quality of life in patients on haemodialysis: a cross-sectional study from Palestine. BMC Nephrol. 2016;17:44.

    PubMed  PubMed Central  Google Scholar 

  49. Coluzzi F, Berti M. Change Pain: changing the approach to chronic pain. Minerva Med. 2011;102:289–307.

    CAS  PubMed  Google Scholar 

  50. Verbeeck RK, Musuamba FT. Pharmacokinetics and dosage adjustment in patients with renal dysfunction. Eur J Clin Pharmacol. 2009;65:757–73.

    CAS  PubMed  Google Scholar 

  51. Rosenberg A, Agiro A, Gottlieb M, Barron J, Brady P, Liu Y, et al. Early trends among seven recommendations from the choosing wisely campaign. JAMA Intern Med. 2015;175:1913–20.

    PubMed  Google Scholar 

  52. Pham PC, Khaing K, Sievers TM, Pham PM, Miller JM, Pham SV, et al. 2017 update on pain management in patients with chronic kidney disease. Clin Kidney J. 2017;10:688–97.

    PubMed  PubMed Central  Google Scholar 

  53. Markell MS. Potential benefits of complementary medicine modalities in patients with chronic kidney disease. Adv Chronic Kidney Dis. 2005;12:292–9.

    PubMed  Google Scholar 

  54. Kim KH, Lee MS, Kim TH, Kang JW, Choi TY, Lee JD. Acupuncture and related interventions for symptoms of chronic kidney disease. Cochrane Database Syst Rev. 2016;(6):CD009440.

  55. Resende L, Merriwether E, Rampazo ÉP, Dailey D, Embree J, Deberg J, et al. Meta-analysis of transcutaneous electrical nerve stimulation for relief of spinal pain. Eur J Pain. 2018;22:663–78.

    CAS  PubMed  Google Scholar 

  56. Walsh DM, Howe TE, Johnson MI, Sluka KA. Transcutaneous electrical nerve stimulation for acute pain. Cochrane Database Syst Rev. 2009;(2):CD006142.

  57. Koca Kutlu A, Eren AG. Effects of music on complications during hemodialysis for chronic renal failure patients. Hemodial Int. 2014;18:777–84.

    PubMed  Google Scholar 

  58. Burrai F, Micheluzzi V, Zito MP, Pietro G, Sisti D. Effects of live saxophone music on physiological parameters, pain, mood and itching levels in patients undergoing haemodialysis. J Ren Care. 2014;40:249–56.

    PubMed  Google Scholar 

  59. Pothoulaki M, Macdonald RA, Flowers P, Stamataki E, Filiopoulos V, Stamatiadis D, et al. An investigation of the effects of music on anxiety and pain perception in patients undergoing haemodialysis treatment. J Health Psychol. 2008;13:912–20.

    CAS  PubMed  Google Scholar 

  60. Cruccu G, Garcia-Larrea L, Hansson P, Keindl M, Lefaucheur JP, Paulus W, et al. EAN guidelines on central neurostimulation therapy in chronic pain conditions. Eur J Neurol. 2016;23:1489–99.

    CAS  PubMed  Google Scholar 

  61. Brater DC. Drug dosing in patients with impaired renal function. Clin Pharmacol Ther. 2009;86:483–9.

    CAS  PubMed  Google Scholar 

  62. Golper TA, Marx MA, Shuler C, Bennett WM. Drug dosage in dialysis patients. In: Jacobs C, Kjellstrand CM, Koch KM, Winchester JF, editors. Replacement of renal function by dialysis. Dordrecht: Kluwer Academic Publishers; 1996. p. 750–820.

    Google Scholar 

  63. Bennett WM, Muther RS, Parker RA, Feig P, Morrison G, Golper TA, et al. Drug therapy in renal failure: dosing guidelines for adults. Part I: antimicrobial agents, analgesics. Ann Intern Med. 1980;93:62–89.

    CAS  PubMed  Google Scholar 

  64. Munar MY, Singh H. Drug dosing adjustments in patients with chronic kidney disease. Am Fam Physician. 2007;75:1487–96.

    PubMed  Google Scholar 

  65. Wu J, Ginsberg JS, Zhan M, Diamantidis CJ, Chen J, Woods C, et al. Chronic pain and analgesic use in CKD: implications for patient safety. Clin J Am Soc Nephrol. 2015;10:435–42.

    PubMed  PubMed Central  Google Scholar 

  66. Martin U, Temple RM, Winney RJ, Prescott LF. The disposition of paracetamol and its conjugates during multiple dosing in patients with end-stage renal failure maintained on haemodialysis. Eur J Clin Pharmacol. 1993;45:141–5.

    CAS  PubMed  Google Scholar 

  67. Lee HS, Ti TY, Lye WC, Khoo YM, Tan CC. Paracetamol and its metabolites in saliva and plasma in chronic dialysis patients. Br J Clin Pharmacol. 1996;41:41–7.

    CAS  PubMed  Google Scholar 

  68. Hernandez SH, Howland M, Schiano TD, Hoffman RS. The pharmacokinetics and extracorporeal removal of N-acetylcysteine during renal replacement therapies. Clin Toxicol (Phila). 2015;53:941–9.

    CAS  Google Scholar 

  69. Morden NE, Colla CH, Sequist TD, Rosenthal MB. Choosing wisely—the politics and economics of labeling low-value services. N Engl J Med. 2014;370:589–92.

    CAS  PubMed  PubMed Central  Google Scholar 

  70. Leonard CE, Freeman CP, Newcomb CW, Reese PP, Herlim M, Bilker WB, et al. Proton pump inhibitors and traditional nonsteroidal anti-inflammatory drugs and the risk of acute interstitial nephritis and acute kidney injury. Pharmacoepidemiol Drug Saf. 2012;21:1155–72.

    CAS  PubMed  Google Scholar 

  71. Zhang X, Donnan PT, Bell S, Guthrie B. Non-steroidal anti-inflammatory drug induced acute kidney injury in the community dwelling general population and people with chronic kidney disease: systematic review and meta-analysis. BMC Nephrol. 2017;18:256.

    PubMed  PubMed Central  Google Scholar 

  72. Swainson CP, Griffiths P. Acute and chronic effects of sulindac on renal function in chronic renal disease. Clin Pharmacol Ther. 1985;37:298–300.

    CAS  PubMed  Google Scholar 

  73. Ravis WR, Diskin CJ, Campagna KD, Clark CR, McMillian CL. Pharmacokinetics and dialyzability of sulindac and metabolites in patients with end-stage renal failure. J Clin Pharmacol. 1993;33:527–34.

    CAS  PubMed  Google Scholar 

  74. Anttila M, Haataja M, Kasanen A. Pharmacokinetics of naproxen in subjects with normal and impaired renal function. Eur J Clin Pharmacol. 1980;18:263–8.

    CAS  PubMed  Google Scholar 

  75. Aronoff GR, Ozawa T, DeSante KA, Nash JF, Ridolfo AS. Benoxaprofen kinetics in renal impairment. Clin Pharmacol Ther. 1982;32:190–4.

    CAS  PubMed  Google Scholar 

  76. Grubb NG, Rudy DW, Brater DC, Hall SD. Stereoselective pharmacokinetics of ketoprofen and ketoprofen glucuronide in end-stage renal disease: evidence for a ‘futile cycle’ of elimination. Br J Clin Pharmacol. 1999;48:494–500.

    CAS  PubMed  PubMed Central  Google Scholar 

  77. al-Ghamdi MS, al-Mohanna FA, al-Mustafa ZH, al-Saeed IS. The effect of haemodialysis on the pharmacokinetics of tenoxicam in patients with end-stage renal disease. Eur J Clin Pharmacol. 1992;43:197–9.

  78. Davies NM, McLachlan AJ, Day RO, Williams KM. Clinical pharmacokinetics and pharmacodynamics of celecoxib: a selective cyclo-oxygenase-2 inhibitor. Clin Pharmacokinet. 2000;38:225–42.

    CAS  PubMed  Google Scholar 

  79. Gottesdiener K, Agrawal N, Porras A, Wong P, Rogers JD, Gertz BJ, et al. Effects of renal insufficiency and hemodialysis on the pharmacokinetics of rofecoxib. Am J Ther. 2003;10:252–8.

    PubMed  Google Scholar 

  80. Heleniak Z, Cieplińska M, Szychliński T, Rychter D, Jagodzińska K, Kłos A, et al. Nonsteroidal anti-inflammatory drug use in patients with chronic kidney disease. J Nephrol. 2017;30:781–6.

    CAS  PubMed  Google Scholar 

  81. Noble M, Treadwell JR, Tregear SJ, Coates VH, Wiffen PJ, Akafomo C, et al. Long‐term opioid management for chronic noncancer pain. Cochrane Database Syst Rev. 2010;(1):CD006605.

  82. Soelberg CD, Brown RE Jr, Du Vivier D, Meyer JE, Ramachandran BK. The US opioid crisis: current federal and state legal issues. Anesth Analg. 2017;125:1675–81.

    PubMed  Google Scholar 

  83. Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain: United States, 2016. JAMA. 2016;315:1624–45.

    CAS  PubMed  PubMed Central  Google Scholar 

  84. O’Brien T, Christrup LL, Drewes AM, Fallon MT, Kress HG, McQuay HJ, et al. European Pain Federation position paper on appropriate opioid use in chronic pain management. Eur J Pain. 2017;21:3–19.

    PubMed  Google Scholar 

  85. Coluzzi F. “I am in pain”: is it really the magic formula to open the door of opioid abuse? Minerva Anestesiol. 2017;83:1332–3.

    PubMed  Google Scholar 

  86. Kurella M, Bennett WM, Chertow GM. Analgesia in patients with ESRD: a review of available evidence. Am J Kidney Dis. 2003;42:217–28.

    CAS  PubMed  Google Scholar 

  87. Wyne A, Rai R, Cuerden M, Clark WF, Suri RS. Opioid and benzodiazepine use in end-stage renal disease: a systematic review. Clin J Am Soc Nephrol. 2011;6:326–33.

    CAS  PubMed  PubMed Central  Google Scholar 

  88. Olivo RE, Hensley RL, Lewis JB, Saha S. Opioid use in hemodialysis patients. Am J Kidney Dis. 2015;66:1103–5.

    PubMed  Google Scholar 

  89. Kimmel PL, Fwu CW, Abbott KC, Eggers AW, Kline PP, Eggers PW. Opioid prescription, morbidity, and mortality in United States dialysis patients. J Am Soc Nephrol. 2017;28:3658–70.

    PubMed  PubMed Central  Google Scholar 

  90. Ishida JH, McCulloch CE, Steinman MA, Grimes BA, Johansen KL. Opioid analgesics and adverse outcomes among hemodialysis patients. Clin J Am Soc Nephrol. 2018;13:746–53.

    PubMed  PubMed Central  Google Scholar 

  91. Butler AM, Kshirsagar AV, Brookhart MA. Opioid use in the US hemodialysis population. Am J Kidney Dis. 2014;63:171–3.

    PubMed  Google Scholar 

  92. Kern DM, Zhou S, Chavoshi S, Tunceli O, Sostek M, Singer J, et al. Treatment patterns, healthcare utilization, and costs of chronic opioid treatment for non-cancer pain in the United States. Am J Manag Care. 2015;21:e222–34.

    PubMed  Google Scholar 

  93. King S, Forbes K, Hanks GW, Ferro CJ, Chambers EJ. A systematic review of the use of opioid medication for those with moderate to severe cancer pain and renal impairment: a European Palliative Care Research Collaborative opioid guidelines project. Palliat Med. 2011;25:525–52.

    CAS  PubMed  Google Scholar 

  94. Coluzzi F, Mattia C. Chronic non-cancer pain: Focus on once-daily tramadol formulations. Ther Clin Risk Manag. 2007;3:819–29.

    CAS  PubMed  PubMed Central  Google Scholar 

  95. Mattia C, Coluzzi F, Sarzi Puttini P, Viganó R. Paracetamol/Tramadol association: the easy solution for mild-moderate pain. Minerva Med. 2008;99:369–90.

    CAS  PubMed  Google Scholar 

  96. Lee CR, McTavish D, Sorkin EM. Tramadol. Drugs. 1993;46:313–40.

    CAS  PubMed  Google Scholar 

  97. Tramadol ER—FDA prescribing information, side effects and uses. Par Pharmaceutical, Inc. 2017. http://www.drugs.com/pro/tramadol-er.html.

  98. Barnung SK, Treshow M, Borgbjerg FM. Respiratory depression following oral tramadol in a patient with impaired renal function. Pain. 1997;71:111–2.

    CAS  PubMed  Google Scholar 

  99. Mattia C, Mazzaferro S, Coluzzi F, Luzi M. Respiratory depression following iatrogenic tramadol overuse in a patient with chronic renal failure. J Headache Pain. 2004;5:137–9.

    CAS  PubMed Central  Google Scholar 

  100. Kirchheiner J, Schmidt H, Tzvetkov M, Keulen JT, Lötsch J, Roots I, et al. Pharmacokinetics of codeine and its metabolite morphine in ultra-rapid metabolizers due to CYP2D6 duplication. Pharmacogenomics J. 2007;7:257–65.

    CAS  PubMed  Google Scholar 

  101. Molanaei H, Carrero JJ, Heimbürger O, Nordfors L, Lindholm B, Stenvinkel P, et al. Influence of the CYP2D6 polymorphism and hemodialysis on codeine disposition in patients with end-stage renal disease. Eur J Clin Pharmacol. 2010;66:269–73.

    CAS  PubMed  Google Scholar 

  102. Dean M. Opioids in renal failure and dialysis patients. J Pain Symptom Manag. 2004;28:497–504.

    CAS  Google Scholar 

  103. Mattia C, Coluzzi F. A look inside the association codeine-paracetamol: clinical pharmacology supports analgesic efficacy. Eur Rev Med Pharmacol Sci. 2015;19:507–16.

    CAS  PubMed  Google Scholar 

  104. Talbott GA, Lynn AM, Levy FH, Zelikovic I. Respiratory arrest precipitated by codeine in a child with chronic renal failure. Clin Pediatr (Phila). 1997;36:171–3.

    CAS  PubMed  Google Scholar 

  105. Sande TA, Laird BJ, Fallon MT. The use of opioids in cancer patients with renal impairment-a systematic review. Support Care Cancer. 2017;25:661–75.

    PubMed  Google Scholar 

  106. Joshi R, Reen B, Sheehan H. Upper extremity diabetic muscle infarction in three patients with endstage renal disease: a case series and review. J Clin Rheumatol. 2009;15:81–4.

    PubMed  Google Scholar 

  107. Han J, Saraf SL, Gordeuk VR, Gowhari M. Safety of chronic transdermal fentanyl use in patients receiving hemodialysis. Am J Health Syst Pharm. 2016;73:947–8.

    PubMed  Google Scholar 

  108. Coluzzi F, Mattia C. Oxycodone. Pharmacological profile and clinical data in chronic pain management. Minerva Anestesiol. 2005;71:451–60.

    CAS  PubMed  Google Scholar 

  109. Samolsky Dekel BG, Donati G, Vasarri A, Croci Chiocchini AL, Gori A, Cavallari G, et al. Dialyzability of oxycodone and its metabolites in chronic noncancer pain patients with end-stage renal disease. Pain Pract. 2017;17:604–15.

    PubMed  Google Scholar 

  110. Hardy JR, Herbert AR, Reymond E. Opioids in patients on renal dialysis. J Pain Symptom Manag. 2007;33:1–2.

    Google Scholar 

  111. Lee MA, Leng ME, Cooper RM. Measurements of plasma oxycodone, noroxycodone and oxymorphone levels in a patient with bilateral nephrectomy who is undergoing haemodialysis. Palliat Med. 2005;19:259–60.

    CAS  PubMed  Google Scholar 

  112. Darwish M, Yang R, Tracewell W, Robertson P Jr, Bond M. effects of renal impairment and hepatic impairment on the pharmacokinetics of hydrocodone after administration of a hydrocodone extended-release tablet formulated with abuse-deterrence technology. Clin Pharmacol Drug Dev. 2016;5:141–9.

    CAS  PubMed  Google Scholar 

  113. Coluzzi F, Mattia C. OROS® hydromorphone in chronic pain management: when drug delivery technology matches clinical needs. Minerva Anestesiol. 2010;76:1072–84.

    CAS  PubMed  Google Scholar 

  114. Pergolizzi J, Aloisi AM, Dahan A, Filitz J, Langford R, Likar R, et al. Current knowledge of buprenorphine and its unique pharmacological profile. Pain Pract. 2010;10:428–50.

    PubMed  Google Scholar 

  115. Pergolizzi JV Jr, Coluzzi F, Taylor R Jr. Transdermal buprenorphine for moderate chronic noncancer pain syndromes. Expert Rev Neurother. 2018. https://doi.org/10.1080/14737175.2018.1462701 (epub 23 Apr 2018).

    Article  PubMed  Google Scholar 

  116. Davis MP. Twelve reasons for considering buprenorphine as a frontline analgesic in the management of pain. J Support Oncol. 2012;10:209–19.

    CAS  PubMed  Google Scholar 

  117. Böger RH. Renal impairment: a challenge for opioid treatment? The role of buprenorphine. Palliat Med. 2006;20(Suppl 1):s17–23.

    PubMed  Google Scholar 

  118. Filitz J, Griessinger N, Sittl R, Likar R, Schüttler J, Koppert W. Effects of intermittent hemodialysis on buprenorphine and norbuprenorphine plasma concentrations in chronic pain patients treated with transdermal buprenorphine. Eur J Pain. 2006;10:743–8.

    CAS  PubMed  Google Scholar 

  119. Hoy SM. Tapentadol extended release: in adults with chronic pain. Drugs. 2012;72:375–93.

    CAS  PubMed  Google Scholar 

  120. Koncicki HM, Unruh M, Schell JO. Pain management in CKD: a guide for nephrology providers. Am J Kidney Dis. 2017;69:451–60.

    PubMed  Google Scholar 

  121. Davies G, Kingswood C, Street M. Pharmacokinetics of opioids in renal dysfunction. Clin Pharmacol Kinet. 1996;31:410–22.

    CAS  Google Scholar 

  122. Deng Y, Luo L, Hu Y, Fang K, Liu J. Clinical practice guidelines for the management of neuropathic pain: a systematic review. BMC Anesthesiol. 2016;16:12.

    PubMed  PubMed Central  Google Scholar 

  123. Campbell JN, Meyer RA. Mechanisms of neuropathic pain. Neuron. 2006;52:77–92.

    CAS  PubMed  PubMed Central  Google Scholar 

  124. Wong M, Eldom M, Keane W, Turk D, Bockbrader H, Underwood B, Sedman A, Halstenson C. Disposition of gabapentin in anuric subjects on hemodialysis. J Clin Pharmacol. 1995;35:622–6.

    CAS  PubMed  Google Scholar 

  125. Zand L, McKian K, Qian Q. Gabapentin toxicity in patients with chronic kidney disease: a preventable cause or morbidity. Am J Med. 2010;123:367–73.

    CAS  PubMed  Google Scholar 

  126. Yoo L, Matalon D, Hoffman RS, Goldfarb DS. Treatment of pregabalin toxicity by hemodialysis in a patient with kidney failure. Am J Kidney Dis. 2009;54:1127–30.

    PubMed  Google Scholar 

  127. Otsuki T, Higuchi T, Yamazaki T, Okawa E, Okada K, Abe M. Efficacy and safety of pregabalin for the treatment of neuropathic pain in patients undergoing hemodialysis. Clin Drug Investig. 2017;37:95–102.

    CAS  PubMed  Google Scholar 

  128. Kaufman KR, Parikh A, Chan L, Bridgeman M, Shah M. Myoclonus in renal failure: two cases of gabapentin toxicity. Epilepsy Behav Case Rep. 2013;2:8–10.

    PubMed  PubMed Central  Google Scholar 

  129. Healy DG, Ingle GT, Brown P. Pregabalin- and gabapentin-associated myoclonus in a patient with chronic renal failure. Mov Disord. 2009;24:2028–9.

    PubMed  Google Scholar 

  130. Binder A, Koroschetz J, Baron R. Disease mechanisms in neuropathic itch. Nat Clin Pract Neurol. 2008;4:329–37.

    PubMed  Google Scholar 

  131. Solak Y, Biyik Z, Atalay H, Gaipov A, Guney F, Turk S, et al. Pregabalin versus gabapentin in the treatment of neuropathic pruritus in maintenance haemodialysis patients: a prospective, crossover study. Nephrology (Carlton). 2012;17:710–7.

    CAS  PubMed  Google Scholar 

  132. Lau T, Leung S, Lau W. Gabapentin for uremic pruritus in hemodialysis patients: a qualitative systematic review. Can J Kidney Health Dis. 2016;3:14.

    PubMed  PubMed Central  Google Scholar 

  133. Beladi Mousavi SS, Zeraati A, Moradi S, Mousavi MB. The effect of gabapentin on muscle cramps during hemodialysis: a double-blind clinical trial. Saudi J Kidney Dis Transpl. 2015;26:1142–8.

    PubMed  Google Scholar 

  134. Maarbjerg S, Di Stefano G, Bendtsen L, Cruccu G. Trigeminal neuralgia—diagnosis and treatment. Cephalalgia. 2017;37:648–57.

    PubMed  Google Scholar 

  135. Kandrotas RJ, Oles KS, Gal P, Love JM. Carbamazepine clearance in hemodialysis and hemoperfusion. DICP. 1989;23:137–40.

    CAS  PubMed  Google Scholar 

  136. Ghannoum M, Yates C, Galvao TF, Sowinski KM, Vo TH, Coogan A, EXTRIP workgroup, et al. Extracorporeal treatment for carbamazepine poisoning: systematic review and recommendations from the EXTRIP workgroup. Clin Toxicol (Phila). 2014;52:993–1004.

    CAS  Google Scholar 

  137. Mahmoud SH. Antiepileptic drug removal by continuous renal replacement therapy: a review of the literature. Clin Drug Investig. 2017;37:7–23.

    CAS  PubMed  Google Scholar 

  138. Mattia C, Paoletti F, Coluzzi F, Boanelli A. New antidepressants in the treatment of neuropathic pain. A review. Minerva Anestesiol. 2002;68:105–14.

    CAS  PubMed  Google Scholar 

  139. Mattia C, Coluzzi F. Antidepressants in chronic neuropathic pain. Mini Rev Med Chem. 2003;3:773–84.

    CAS  PubMed  Google Scholar 

  140. Lobo ED, Heathman M, Kuan HY, Reddy S, O’Brien L, Gonzales C, et al. Effects of varying degrees of renal impairment on the pharmacokinetics of duloxetine: analysis of a single-dose phase I study and pooled steady-state data from phase II/III trials. Clin Pharmacokinet. 2010;49:311–21.

    CAS  PubMed  Google Scholar 

  141. Troy SM, Schultz RW, Parker VD, Chiang ST, Blum RA. The effect of renal disease on the disposition of venlafaxine. Clin Pharmacol Ther. 1994;56:14–21.

    CAS  PubMed  Google Scholar 

  142. Pena-Polanco JE, Mor MK, Tohme FA, Fine MJ, Palevsky PM, Weisbord SD. Acceptance of antidepressant treatment by patients on hemodialysis and their renal providers. Clin J Am Soc Nephrol. 2017;12:298–303.

    PubMed  PubMed Central  Google Scholar 

  143. Mathew RO, Bettinger JJ, Wegrzyn EL, Fudin J. Pharmacotherapeutic considerations for chronic pain in chronic kidney and end-stage renal disease. J Pain Res. 2016;9:1191–5.

    CAS  PubMed  PubMed Central  Google Scholar 

  144. Nagler EV, Webster AC, Vanholder R, Zoccali C. Antidepressants for depression in stage 3–5 chronic kidney disease: a systematic review of pharmacokinetics, efficacy and safety with recommendations by European Renal Best Practice (ERBP). Nephrol Dial Transplant. 2012;27:3736–45.

    CAS  PubMed  Google Scholar 

  145. Eyler RF, Unruh ML, Quinn DK, Vilay AM. Psychotherapeutic agents in end-stage renal disease. Semin Dial. 2015;28:417–26.

    PubMed  Google Scholar 

  146. Pickering G, Martin E, Tiberghien F, Delorme C, Mick G. Localized neuropathic pain: an expert consensus on local treatments. Drug Des Devel Ther. 2017;11:2709–18.

    CAS  PubMed  PubMed Central  Google Scholar 

  147. Sommer C, Cruccu G. Topical treatment of peripheral neuropathic pain: applying the evidence. J Pain Symptom Manag. 2017;53:614–29.

    Google Scholar 

  148. Finnerup NB, Attal N, Haroutounian S, McNicol E, Baron R, Dworkin RH, et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol. 2015;14:162–73.

    CAS  PubMed  PubMed Central  Google Scholar 

  149. Baron R, Allegri M, Correa-Illanes G, Hans G, Serpell M, Mick G, et al. The 5% lidocaine-medicated plaster: its inclusion in international treatment guidelines for treating localized neuropathic pain, and clinical evidence supporting its use. Pain Ther. 2016;5:149–69.

    PubMed  PubMed Central  Google Scholar 

  150. Navez ML, Monella C, Bösl I, Sommer D, Delorme C. 5% lidocaine-medicated plaster for the treatment of postherpetic neuralgia: a review of the clinical safety and tolerability. Pain Ther. 2015;4:1–15.

    PubMed  PubMed Central  Google Scholar 

  151. Wolff RF, Bala MM, Westwood M, Kessels AG, Kleijnen J. 5% lidocaine-medicated plaster in painful diabetic peripheral neuropathy (DPN): a systematic review. Swiss Med Wkly. 2010;140:297–306.

    CAS  PubMed  Google Scholar 

  152. Campbell BJ, Rowbotham M, Davies PS, Jacob P 3rd, Benowitz NL. Systemic absorption of topical lidocaine in normal volunteers, patients with post-herpetic neuralgia, and patients with acute herpes zoster. J Pharm Sci. 2002;91:1343–50.

    CAS  PubMed  Google Scholar 

  153. Bruckenthal P, Barkin RL. Options for treating postherpetic neuralgia in the medically complicated patient. Ther Clin Risk Manag. 2013;9:329–40.

    CAS  PubMed  PubMed Central  Google Scholar 

  154. Jones VM, Moore KA, Peterson DM. Capsaicin 8% topical patch (Qutenza)—a review of the evidence. J Pain Palliat Care Pharmacother. 2011;25:32–41.

    PubMed  Google Scholar 

  155. Babbar S, Marier JF, Mouksassi MS, Beliveau M, Vanhove GF, Chanda S, et al. Pharmacokinetic analysis of capsaicin after topical administration of a high-concentration capsaicin patch to patients with peripheral neuropathic pain. Ther Drug Monit. 2009;31:502–10.

    CAS  PubMed  Google Scholar 

  156. Aitken E, McColl G, Kingsmore D. The role of Qutenza® (topical capsaicin 8%) in treating neuropathic pain from critical ischemia in patients with end-stage renal disease: an observational cohort study. Pain Med. 2017;18:330–40.

    PubMed  Google Scholar 

  157. Benini F, Gobber D, Lago P, Agosto C, Carli G, Zachello F. Pain management of arteriovenous fistula cannulation in haemodialysis children: efficacy of EMLA anaesthetic cream. Eur J Pain. 1998;2:109–13.

    CAS  PubMed  Google Scholar 

  158. Çelik G, Özbek O, Yilmaz MM, Duman I, Özbek S, Apiliogullari S. Vapocoolant spray vs. lidocaine/prilocaine cream for reducing the pain of venipuncture in hemodialysis patients: a randomized, placebo-controlled crossover study. Int J Med Sci. 2011;8:623–7.

    PubMed  PubMed Central  Google Scholar 

  159. Pergolizzi JV Jr, Lequang JA, Taylor R Jr, Raffa RB, Colucci D, NEMA Research Group. The role of cannabinoids in pain control: the good, the bad, and the ugly. Minerva Anestesiol. 2018;84:955–69.

    PubMed  Google Scholar 

  160. Coluzzi F. Cannabinoids in chronic pain management: a skein to be untangled. Minerva Anestesiol. 2018;84:893–5.

    PubMed  Google Scholar 

  161. Rein JL, Wyatt CM. Marijuana and cannabinoids in ESRD and earlier stages of CKD. Am J Kidney Dis. 2018;71:267–74.

    CAS  PubMed  Google Scholar 

  162. Chen NC, Hsu CY, Chen CL. The strategy to prevent and regress the vascular calcification in dialysis patients. Biomed Res Int. 2017;2017:9035193.

    PubMed  PubMed Central  Google Scholar 

  163. Toussaint ND, Elder GJ, Kerr PG. Bisphosphonates in chronic kidney disease; balancing potential benefits and adverse effects on bone and soft tissue. Clin J Am Soc Nephrol. 2009;4:221–33.

    CAS  PubMed  Google Scholar 

  164. Mattia C, Coluzzi F, Celidonio L, Vellucci R. Bone pain mechanism in osteoporosis: a narrative review. Clin Cases Miner Bone Metab. 2016;13:97–100.

    PubMed  PubMed Central  Google Scholar 

  165. Mccormick BB, Davis J, Burns KD. Severe hypocalcemia following denosumab injection in a hemodialysis patient. Am J Kidney Dis. 2012;60:626–8.

    PubMed  Google Scholar 

  166. Uehara A, Yazawa M, Kawata A, Hachisuka R, Shibagaki Y. Denosumab for treatment of immobilization-related hypercalcemia in a patient with end-stage renal disease. CEN Case Rep. 2017;6:111–4.

    PubMed  PubMed Central  Google Scholar 

  167. Morley-Forster PK, Pergolizzi JV, Taylor R Jr, Axford-Gatley RA, Sellers EM. Mitigating the risk of opioid abuse through a balanced undergraduate pain medicine curriculum. J Pain Res. 2013;6:791–801.

    PubMed  PubMed Central  Google Scholar 

  168. Zyga S, Alikari V, Sachlas A, Stathoulis J, Aroni A, Theofilou P, et al. Management of pain and quality of life in patients with chronic kidney disease undergoing hemodialysis. Pain Manag Nurs. 2015;16:712–20.

    PubMed  Google Scholar 

  169. Davison SN. Pain, analgesics, and safety in patients with CKD. Clin J Am Soc Nephrol. 2015;10:350–2.

    PubMed  PubMed Central  Google Scholar 

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  1. Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy

    Flaminia Coluzzi

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Coluzzi, F. Assessing and Treating Chronic Pain in Patients with End-Stage Renal Disease. Drugs 78, 1459–1479 (2018). https://doi.org/10.1007/s40265-018-0980-9

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