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肾移植受者和慢性血液透析患者疼痛的患病率相似,但特征不同。

Similar prevalence but different characteristics of pain in kidney transplant recipients and chronic hemodialysis patients.

机构信息

Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Łódź, Łódź, Poland.

出版信息

Clin Transplant. 2011 Mar-Apr;25(2):E144-51. doi: 10.1111/j.1399-0012.2010.01359.x. Epub 2010 Nov 17.

Abstract

BACKGROUND

Chronic pain is frequent in both hemodialysis (HD) patients and kidney transplant (KTx) recipients but its detailed characteristics have never been thoroughly investigated.

AIM

To compare prevalence of pain, its locations and characteristics, and analgesics use in chronic HD and KTx patients.

METHODS

A cross-sectional comparative study in 164 HD patients and 114 stable deceased donor KTx recipients. All participants completed the modified McGill Pain Questionnaire.

RESULTS

Overall, 63% of HD patients and 62% of KTx patients reported pain. Fifty-four percent of HD patients and 67% of KTx patients indicated more than one location of pain. Severe pain was more common in HD patients, and prevalence of pain-associated symptoms from major body systems was higher in HD patients. Pain in both groups was mostly local, paroxysmal and/or chronic. Fifteen percent of HD patients and 37% of KTx patients with chronic pain were not receiving pain relief drugs. The general feeling of illness was lower in KTx than HD patients (4.54 ± 2.1 vs. 5.6 ± 0.7; p < 0.0001); however, in the former group, it was systematically increasing with the time after transplantation.

CONCLUSIONS

A successful kidney transplantation does not lead to a significant reduction in the prevalence of pain when compared to chronic HD patients. Pain relief medications are underused in KTx patients.

摘要

背景

慢性疼痛在血液透析(HD)患者和肾移植(KTx)受者中都很常见,但对其详细特征尚未进行过全面研究。

目的

比较慢性 HD 患者和 KTx 患者疼痛的发生率、部位和特征以及镇痛药的使用情况。

方法

这是一项横断面对比研究,纳入了 164 例 HD 患者和 114 例稳定的已故供体 KTx 受者。所有参与者均完成了改良 McGill 疼痛问卷。

结果

总体而言,63%的 HD 患者和 62%的 KTx 患者报告有疼痛。54%的 HD 患者和 67%的 KTx 患者表示有一个以上部位的疼痛。HD 患者疼痛更剧烈,且疼痛相关症状在主要身体系统中的发生率更高。两组患者的疼痛均主要为局部、阵发性和/或慢性疼痛。15%的慢性疼痛 HD 患者和 37%的慢性疼痛 KTx 患者未使用止痛药物。与 HD 患者相比,KTx 患者的整体疾病感觉较低(4.54±2.1 比 5.6±0.7;p<0.0001);然而,在前一组患者中,这种感觉会随着移植后时间的推移而系统性地增加。

结论

与慢性 HD 患者相比,成功的肾移植并不能显著降低疼痛的发生率。KTx 患者对疼痛缓解药物的使用不足。

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