title: Pain management in patients with chronic kidney disease.
abstract: Pain has been reported to be a common problem in the general population and end-stage renal disease (ESRD) patients. Although similar data for pre-ESRD patients are lacking, we recently reported that the prevalence of pain is also very high (>70%) among pre-ESRD patients at a Los Angeles County tertiary referral centre. The high prevalence of pain in the CKD population is particularly concerning because pain has been shown to be associated with poor quality of life. Of greater concern, poor quality of life, at least in dialysis patients, has been shown to be associated with poor survival. We herein discuss the pathophysiology of common pain conditions, review a commonly accepted approach to the management of pain in the general population, and discuss analgesic-induced renal complications and therapeutic issues specific for patients with reduced renal function.
authors.affiliation: Nephrology Division, Department of Medicine, Olive View-UCLA Medical Center, Sylmar.
authors.forename: Phuong-Chi T
authors.initials: PC
authors.lastname: Pham
authors.affiliation: Nephrology Division, Department of Medicine, Olive View-UCLA Medical Center, Sylmar.
authors.forename: Edgar
authors.initials: E
authors.lastname: Toscano
authors.affiliation: Department of Medicine, Greater Los Angeles VA Medical Center, Los Angeles.
authors.forename: Phuong-Mai T
authors.initials: PM
authors.lastname: Pham
authors.affiliation: Mercy General Hospital , Sacramento.
authors.forename: Phuong-Anh T
authors.initials: PA
authors.lastname: Pham
authors.affiliation: Cardiology Division, Good Samaritan Hospital/Harbor-UCLA Medical Center, Los Angeles.
authors.forename: Son V
authors.initials: SV
authors.lastname: Pham
authors.affiliation: David Geffen School of Medicine at UCLA, Kidney and Pancreas Transplant Program, Los Angeles, CA , USA.
authors.forename: Phuong-Thu T
authors.initials: PT
authors.lastname: Pham
keywords: NSAIDS; analgesics; chronic kidney disease; opioids; pain