Sadigova Esmira, Ozkurt Sultan, Yalcin Ahmet Ugur
Internal Medicine, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, TUR.
Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, TUR.
Cureus. 2020 Feb 6;12(2):e6903. doi: 10.7759/cureus.6903.
Background Pain is a common complaint among hemodialysis (HD) patients; however, most patients are not assessed for this aspect and are not sufficiently treated. In these patients, pain is reported to be associated with a range of parameters like increased depression and disrupted quality of life (QOL). Previously residual renal function (RRF) was not assessed for associations with pain. The primary aim of the study is to evaluate the pain frequency in the Turkish HD patient population. In addition, the type, origin, and severity of chronic pain, the pain treatment ratio, and the relationship between pain, QOL, and RRF were investigated during the study. Methods This study included 328 HD patients. Pain assessment used the McGill Pain Questionnaire and neuropathic pain assessment used the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale. The correlation of pain and quality of life was evaluated with the Short Form 36 (SF-36) quality of life scale. Results Of patients, 244 experienced pain (74.4%), and this pain had a neuropathic character in 61.8% of these patients. Patients with pain had a longer dialysis duration than those without pain (4.00 (2.00-8.00), 3.00 (2.00-4.75), p=0.01). The most common site of pain was the lower extremities. Pain was observed more often among females and with increasing age. Only 36.4% of patients used analgesics. The quality of life of patients with pain was found to be lower. The incidence of pain was higher among patients without RRF and had more neuropathic character. Conclusions Pain is a significant problem for the majority of HD patients and is not effectively managed. To increase the quality of life of patients, the care team should regularly question pain symptoms, and it should be treated effectively. In this context, RRF should be regularly monitored and efforts should be made to preserve it.
背景 疼痛是血液透析(HD)患者常见的主诉;然而,大多数患者未接受这方面的评估,也未得到充分治疗。据报道,这些患者的疼痛与一系列参数相关,如抑郁加重和生活质量(QOL)受损。此前,未评估残余肾功能(RRF)与疼痛的关联。本研究的主要目的是评估土耳其HD患者群体中的疼痛发生率。此外,在研究过程中还调查了慢性疼痛的类型、起源和严重程度、疼痛治疗率以及疼痛、QOL和RRF之间的关系。
方法 本研究纳入了328例HD患者。疼痛评估采用麦吉尔疼痛问卷,神经性疼痛评估采用利兹神经性症状和体征评估(LANSS)量表。采用简短健康调查36(SF-36)生活质量量表评估疼痛与生活质量的相关性。
结果 患者中,244例经历过疼痛(74.4%),其中61.8%的患者疼痛具有神经性特征。有疼痛的患者透析时间比无疼痛的患者长(4.00(2.00 - 8.00),3.00(2.00 - 4.75),p = 0.01)。最常见的疼痛部位是下肢。女性和年龄较大的患者疼痛更为常见。仅36.4%的患者使用了镇痛药。发现有疼痛的患者生活质量较低。无RRF的患者疼痛发生率更高,且更具神经性特征。
结论 疼痛是大多数HD患者的一个重要问题,且未得到有效管理。为提高患者生活质量,护理团队应定期询问疼痛症状,并进行有效治疗。在此背景下,应定期监测RRF,并努力保护它。