Opioid Management in Older Adults with Chronic Kidney Disease: A Review

Chronic pain, a common comorbidity of chronic kidney disease, is consistently under-recognized and difficult to treat in older adults with non-dialysis chronic kidney disease. Given the decreased kidney function associated with aging and chronic kidney disease, these patients are at increased risk for drug accumulation and adverse events. Emerging research has demonstrated the efficacy of opioids in chronic kidney disease patients, but research specifically focusing on older, non-dialysis chronic kidney disease patients is scarce.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Review Source Type: research

Related Links:

Guidelines recommend advance care planning (ACP) as essential to quality chronic kidney disease (CKD) management, but the nephrology community has yet to incorporate ACP upstream of the dialysis decision. Others have attempted to improve ACP for dialysis patients, but many patients report wishing they had been engaged in ACP earlier. This project tested integration of ACP coaching in the upstream setting of nephrology offices.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
Abstract Chronic kidney disease (CKD) is a major health problem. The purpose of this qualitative study was to describe nephrology nurses' experiences in assessing and managing pain in patients who were receiving maintenance hemodialysis at outpatient units within a tertiary care institution. Semi-structured interviews were conducted with seven nurses, and a thematic analysis was used to analyze data. Themes emerged related to the complexity of pain assessment and management in these patients, who were often elderly. Nurses had to ascertain whether the pain was related to hemodialysis treatment, renal failure, or c...
Source: Nephrology Nursing Journal - Category: Nursing Authors: Tags: Nephrol Nurs J Source Type: research
Publication date: November 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 6Author(s): Harish Seethapathy, Lama NoureddineCalciphylaxis is a rare disorder of poor prognosis that can lead to intense, painful lesions involving the skin and subcutaneous tissue. Although mostly described in dialysis patients, it can affect patients with normal kidney function. The diagnosis of calciphylaxis is complicated by the absence of a gold standard marker of disease such as a clear histopathological finding. Late diagnosis and advanced lesions can significantly shorten life expectancy. Calciphylaxis wounds can have a ma...
Source: Advances in Chronic Kidney Disease - Category: Urology & Nephrology Source Type: research
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
As multiple different studies and surveys continue to illustrate, palliative and hospice medicine has failed to have an appropriate impact on the quality of life for the end-stage renal disease (ESRD) population. People with Chronic Kidney Disease (CKD) remain less likely to die at home, spend more time in the hospital and at higher costs in the last 3 months of life. (Kerr M et al, NDT, 2016).
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
As chronic kidney disease progresses to end-stage renal disease (ESRD), important discussions regarding when and if to initiate dialysis occur. ESRD affects more than 660,000 Americans, less than 10,000 (1.5%) of those are pediatric patients whose time on dialysis is typically meant as a bridge to transplant. In rare circumstances, comorbidities, such as multiorgan failure, progression of other life-threating medical conditions, congenital anomalies, and size restrictions limit pediatric candidates ’ access to transplant.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
Chronic kidney disease (CKD) is increasingly common in the aging population, and the highest incidence of patients starting dialysis is those 75 years of age and older. Patients over the age of 67 face mortality rates as high as 23% at 6 months, though there exists great variability. Older patients with advanced CKD are more likely to have comorbidities including cognitive and functional limitations. Symptom burden is high and does not consistently improve, and may worsen, after starting dialysis.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
Despite advances in pre-dialysis care and dialysis technology, patients with advanced chronic kidney disease and end-stage renal disease continue to experience multiple comorbidities, a high symptom burden, a shortened life expectancy and substantial physical, emotional, and spiritual suffering. Patients with acute kidney injury and end-stage renal disease, especially if they are older, often undergo prolonged hospitalizations, greater use of intensive medical treatment, and limited survival. Unfortunately, most nephrologists are not trained to conduct shared decision-making conversations to elicit patients ’ values,...
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
Despite advances in predialysis care and dialysis technology, patients with advanced chronic kidney disease and end-stage renal disease continue to experience multiple comorbidities, a high symptom burden, a shortened life expectancy, and substantial physical, emotional, and spiritual suffering. Patients with acute kidney injury and end-stage renal disease, especially if they are older, often undergo prolonged hospitalizations, greater use of intensive medical treatment, and limited survival. Unfortunately, most nephrologists are not trained to conduct shared decision-making conversations to elicit patients' values, prefer...
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Tags: Curbside Rounds: State-of-the-Art in Palliative Care Source Type: research
CONCLUSION: Patients with CKD often take NSAIDs. This applies especially to the group of people undergoing hemodialysis, which is mainly associated with chronic osteo-articular pain. The results also show a low awareness of painkillers' adverse effects. PMID: 27679400 [PubMed - as supplied by publisher]
Source: Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: J Nephrol Source Type: research
More News: Chronic Kidney Disease | Chronic Pain | Dialysis | General Medicine | Pain | Pain Management | Urology & Nephrology