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维持性透析患者使用大麻治疗不宁腿综合征和尿毒症瘙痒的调查

Cannabis Use for Restless Legs Syndrome and Uremic Pruritus in in patients treated with maintenance dialysis: A Survey.

作者信息

Samaha Daniel, Kandiah Trisha, Zimmerman Deborah

机构信息

Division of Nephrology, Department of Medicine, The Ottawa Hospital, ON, Canada.

Kidney Research Centre, Ottawa Hospital Research Institute, ON, Canada.

出版信息

Can J Kidney Health Dis. 2020 Sep 10;7:2054358120954944. doi: 10.1177/2054358120954944. eCollection 2020.

Abstract

BACKGROUND

Restless legs syndrome (RLS) and uremic pruritus reduce the quality of life in patients with end-stage kidney disease (ESKD) and current treatments are often insufficient. There is an increasing interest in using cannabinoids for symptom management, and preliminary evidence suggests cannabinoids may help alleviate RLS and pruritus.

OBJECTIVES

(1) To assess the frequency and severity of RLS and pruritus in our ESKD population with the current treatment options, (2) to estimate patient use of cannabinoids for these symptoms, and (3) to determine interest in participating in future trials to treat RLS and/or pruritus.

DESIGN

Survey.

PATIENTS

Adult prevalent patients with ESKD treated with dialysis at the Ottawa Hospital.

MEASUREMENTS

International RLS Study Group Rating Scale and visual analogue scale for symptom severity of RLS and pruritus, respectively.

METHODS

Eligible patients with ESKD treated at the Ottawa Hospital were invited to complete a survey to identify symptoms and severity of RLS and pruritus using validated scales, cannabis use for management, and interest in future trials. Basic demographic statistics to describe the study population and results were used.

RESULTS

Sixty-nine percent (192 of 277) of eligible patients completed the surveys, 35 declined participation, and 50 surveys were not returned. Eighty-six (45%) and 129 patients (67%) reported symptoms of RLS and pruritus, respectively. Only 18 previously symptomatic patients were relieved with current treatment. Fifteen patients reported cannabis use for symptoms; 9 noted improvement. Most (>2 of 3) symptomatic patients were interested in participating in a future trial.

LIMITATIONS

Single-center study in a tertiary-care hospital in Canada limiting generalizability. Quoted prevalence of symptoms is dependent on survey return.

CONCLUSIONS

A large proportion of ESKD patients suffer from RLS and/or pruritus, most of which are not relieved by existing treatments. Few patients reported trying cannabis to decrease their symptoms despite legalization. This study confirms strong patient interest for future trials regarding cannabis for symptom relief.

TRIAL REGISTRATION

Not applicable.

摘要

背景

不宁腿综合征(RLS)和尿毒症瘙痒会降低终末期肾病(ESKD)患者的生活质量,而目前的治疗方法往往效果不佳。人们越来越关注使用大麻素进行症状管理,初步证据表明大麻素可能有助于缓解RLS和瘙痒。

目的

(1)评估在我们接受当前治疗方案的ESKD患者中RLS和瘙痒的频率及严重程度;(2)估计患者使用大麻素治疗这些症状的情况;(3)确定参与未来治疗RLS和/或瘙痒试验的意愿。

设计

调查。

患者

在渥太华医院接受透析治疗的成年ESKD现患患者。

测量

分别采用国际RLS研究组评分量表和视觉模拟量表评估RLS和瘙痒的症状严重程度。

方法

邀请在渥太华医院接受治疗的符合条件的ESKD患者完成一项调查,以使用经过验证的量表确定RLS和瘙痒的症状及严重程度、使用大麻进行管理的情况以及对未来试验的意愿。使用基本人口统计学统计数据来描述研究人群和结果。

结果

69%(277名中的192名)符合条件的患者完成了调查,35人拒绝参与,50份调查问卷未返回。分别有86名(45%)和129名患者(67%)报告有RLS和瘙痒症状。目前的治疗仅使18名既往有症状的患者症状缓解。15名患者报告使用大麻治疗症状,其中9名表示症状改善。大多数(超过三分之二)有症状的患者有兴趣参与未来的试验。

局限性

在加拿大一家三级护理医院进行的单中心研究,限制了研究结果的普遍性。所引用的症状患病率取决于调查问卷的返回情况。

结论

很大一部分ESKD患者患有RLS和/或瘙痒,大多数患者的症状无法通过现有治疗得到缓解。尽管大麻已合法化,但很少有患者报告尝试使用大麻来减轻症状。本研究证实患者对未来关于大麻缓解症状的试验有浓厚兴趣。

试验注册

不适用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5681/7488602/b377f275074e/10.1177_2054358120954944-fig1.jpg

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