title: A stepwise approach for effective management of chronic pain in autosomal-dominant polycystic kidney disease.
abstract: Chronic pain, defined as pain existing for >4-6 weeks, affects >60% of patients with autosomal-dominant polycystic disease (ADPKD). It can have various causes, indirectly or directly related to the increase in kidney and liver volume in these patients. Chronic pain in ADPKD patients is often severe, impacting physical activity and social relationships, and frequently difficult to manage. This review provides an overview of pathophysiological mechanisms that can lead to pain and discusses the sensory innervation of the kidneys and the upper abdominal organs, including the liver. In addition, the results of a systematic literature search of ADPKD-specific treatment options are presented. Based on pathophysiological knowledge and evidence derived from the literature an argumentative stepwise approach for effective management of chronic pain in ADPKD is proposed.
authors.affiliation: Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Niek F
authors.initials: NF
authors.lastname: Casteleijn
authors.affiliation: Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Folkert W
authors.initials: FW
authors.lastname: Visser
authors.affiliation: Department of Gastroenterology and Hepatology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands.
authors.forename: Joost P H
authors.initials: JP
authors.lastname: Drenth
authors.affiliation: Department of Gastroenterology and Hepatology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands.
authors.forename: Tom J G
authors.initials: TJ
authors.lastname: Gevers
authors.affiliation: Pain Centre, Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Gerbrand J
authors.initials: GJ
authors.lastname: Groen
authors.affiliation: Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Marie C
authors.initials: MC
authors.lastname: Hogan
authors.affiliation: Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Ron T
authors.initials: RT
authors.lastname: Gansevoort
mesh_terms: D059350:Chronic Pain / Q000209:etiology / Q000517:prevention & control*; D019468:Disease Management; D006801:Humans; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications*
keywords: ADPKD; management; pain; polycystic kidney disease; polycystic liver disease