Division of Nephrology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
Division of Nephrology, Department of Medicine, Dalhousie University, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.
J Pain Symptom Manage. 2021 Feb;61(2):237-245.e2. doi: 10.1016/j.jpainsymman.2020.08.003. Epub 2020 Aug 14.
The efficacy and safety of cannabinoids to treat symptoms in individuals with kidney disease is uncertain.
We sought to elicit Canadian nephrologists' views regarding the use and study of cannabinoids in patients with kidney disease in an Internet-based survey of Canadian of Society of Nephrology members treating adult patients with kidney disease including dialysis.
The degree to which respondents supported the use or study of cannabinoids for symptoms common in kidney disease was assessed using a modified Likert scale ranging from 1 to 7 (anchored at 1-definitely would not and 7-being definitely would). Participants were asked their degree of support for cannabinoid use in clinical practice and for randomized controlled trials examining cannabinoids for anxiety, depression, restless legs syndrome, itchiness, fatigue, chronic pain, decreased appetite, nausea/vomiting, sleep disorder, and others. Multilevel multivariable linear regression was used to identify independent predictors of the degree of support.
There were 151 (43.4%) responses from 348 eligible participants. One hundred twenty-four (82%) previously cared for patients using prescribed cannabinoids by other providers, and 29 (19%) had previously prescribed cannabinoids themselves. One hundred thirty-seven (91%) had previously cared for patients using nonprescription cannabinoids, which were used most commonly recreationally (88.3%), for chronic pain (73.7%) or for anxiety (52.6%). Respondents supported the use of cannabinoids (mean score >5) for each symptom in the setting of refractory symptoms. Similarly, respondents supported enrolling patients for trials for all symptoms (mean scores >5).
Nephrologists broadly support the use and study of cannabinoids for symptoms in patients with kidney disease.
大麻素治疗肾脏病患者症状的疗效和安全性尚不确定。
我们通过对加拿大肾脏病学会成员进行基于互联网的调查,旨在了解加拿大肾脏病医生对大麻素在肾脏病患者中的使用和研究的看法,这些医生治疗的是成年肾脏病患者,包括透析患者。
采用改良 Likert 量表(范围为 1-7,1 表示绝对不会,7 表示绝对会)评估受访者对大麻素治疗肾脏病常见症状的使用或研究的支持程度。参与者被问及他们对大麻素在临床实践中的使用以及对大麻素治疗焦虑、抑郁、不安腿综合征、瘙痒、疲劳、慢性疼痛、食欲减退、恶心/呕吐、睡眠障碍和其他症状的随机对照试验的支持程度。采用多层次多变量线性回归分析确定支持程度的独立预测因素。
在 348 名符合条件的参与者中,有 151 名(43.4%)做出了回应。124 名(82%)曾照顾过其他提供者开处方大麻素的患者,29 名(19%)曾自己开过大麻素处方。137 名(91%)曾照顾过使用非处方大麻素的患者,这些患者最常因慢性疼痛(73.7%)、焦虑(52.6%)或疼痛(52.6%)而使用非处方大麻素。受访者支持在难治性症状的情况下使用大麻素(平均得分>5)治疗每种症状。同样,受访者支持招募所有症状(平均得分>5)的患者参加试验。
肾脏病医生普遍支持在肾脏病患者中使用和研究大麻素治疗症状。