Kawano Takashi, Yokoyama Masataka
Department of Anesthesiology and Intensive Care Medicine, Kochi Medical School, Nankoku 783-8505.
Masui. 2013 Nov;62(11):1344-50.
Chronic kidney disease (CKD), defined by abnormalities in kidney function or damage stable for more than three months, is a relatively common disease in Japan. A high prevalence of pain-associated disease is reported in the CKD population. Thus, there is ample opportunity to manage pain in patients with CKD in ordinary clinical practice. When administering analgesics to patients with CKD, we should be careful about the status of renal function and the renal excretion rates of parent drug and/or its metabolites, to prevent drug accumulation and increased risk of toxicity. Furthermore, certain analgesics can increase the risk of acute kidney injury and they should be avoided in CKD patients. The aim of this article is to review the considerations needed for pain management in CKD patients.
慢性肾脏病（CKD）是指肾脏功能异常或损伤持续稳定超过三个月的疾病，在日本是一种相对常见的疾病。据报道，CKD患者中疼痛相关疾病的患病率较高。因此，在普通临床实践中，有充分的机会对CKD患者进行疼痛管理。在给CKD患者使用镇痛药时，我们应注意肾功能状况以及母体药物和/或其代谢产物的肾脏排泄率，以防止药物蓄积和毒性风险增加。此外，某些镇痛药会增加急性肾损伤的风险，CKD患者应避免使用。本文的目的是综述CKD患者疼痛管理所需考虑的因素。
