Abstract: TH-PO798

Chronic Pain Poses a Significant Burden on Lives of Dialysis Patients

Session Information

Category: Dialysis

  • 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Authors

  • Culkin, Nancy, DaVita, Inc, Denver, Colorado, United States
  • Aebel-Groesch, Kathryn M., DaVita, Inc, Denver, Colorado, United States
  • Dunn, Duane V., DaVita, Inc, Denver, Colorado, United States
  • Mayes, Sean, DaVita, Inc, Denver, Colorado, United States
  • Benner, Deborah A., DaVita, Inc, Denver, Colorado, United States
  • Tentori, Francesca, DaVita Clinical Research, Minneapolis, Minnesota, United States
Background

Chronic pain is common in end-stage renal disease (ESRD) due both to multiple comorbidities as well as the dialysis treatment itself. Given differences in dialysis treatment and underlying health status, it is possible that pain perception and burden may differ for in-center hemodialysis (ICHD) and peritoneal dialysis (PD) patients. We characterized the impact of pain on the daily life among patients treated in a large dialysis organization (LDO).

Methods

Pain was assessed monthly by LDO nurses using the Wong-Baker 0-10 scale (May 2016-April 2017). For those patients indicating the presence of pain (rating ≥ 2), a follow-up survey was administered further assessing pain characteristics and burden.

Results

There were a total of 1,094,897 pain assessments performed for ICHD patients (6.5 screenings per patient on average) and 173,739 for PD patients (7.2 screenings per patient on average). Of these, 161,800 (14.8%) ICHD and 23,101 (13.3%) PD assessments had ratings ≥ 2. Back pain was the most common location for both modalities. ICHD patients were more likely to report dialysis-related pain (8.5% responses, 5.7% in PD) and pain of duration ≥ 3 weeks (73.8% vs. 67.0%). Chronic pain had a great impact on lives of both ICHD and PD patients. Use of pain medications was more common in ICHD (74.8%) vs PD (65.1%). For both modalities, acetaminophen was the most common pain medication (~ 30% responses) followed by hydrocodone/acetaminophen (ICHD 15.4%, PD 13.5%).

Conclusion

Our results indicate that pain poses a great burden on lives of dialysis patients, affecting many everyday activities and likely contributing to depressive symptoms. Interestingly, perception of pain and its impact were largely similar between ICHD and PD patients, suggesting that the dialysis treatment process may only play a marginal role. There is a need to integrate pain management in the care of dialysis patients in order to optimize quality of life.

Funding

  • Commercial Support