探讨与血液透析患者疼痛相关的因素：来自巴勒斯坦的一项多中心横断面研究。
Exploring factors associated with pain in hemodialysis patients: a multicenter cross-sectional study from Palestine.
机构信息
Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, 44839, Nablus, Palestine.
Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, 44839, Nablus, Palestine.
出版信息
BMC Nephrol. 2021 Mar 17;22(1):96. doi: 10.1186/s12882-021-02305-1.
BACKGROUND
Chronic kidney disease (CKD) is a rising medical concern around the world. End-stage kidney disease (ESKD) is the last stage of CKD stages that necessitates renal replacement therapy (RRT), such as hemodialysis (HD), which seems to be the most commonly used type. However, patients on HD still suffer from high mortality and morbidity rates compared to those who receive a kidney transplant. Therefore, we aimed in this study to assess the prevalence of pain among ESKD patients on HD, as well as to explore the factors that were associated with this complaint.
METHODS
We conducted a multicenter cross-sectional study in the West Bank, Palestine, between August and November 2018. We used questionnaire-based direct interviews with subjects. After reviewing previous studies in the field, we developed our questionnaire and included items on patients' social, demographic, and clinical characteristics, including dialysis-related data. It also contained the Brief Pain Inventory (BPI) to assess different aspects of pain symptoms. A convenience sampling technique was used to collect data.
RESULTS
Of the 300 participants, 66.3 % reported having chronic pain. HD sessions themselves were the most commonly cited cause for pain (21.6 %). The most commonly cited site of pain was the upper and lower limbs (37.3 %). Paracetamol was the most frequently used pharmacotherapy for pain alleviation. Multiple regression analysis showed that BMI (p = 0.018), gender (p = 0.023), and the number of comorbidities (p < 0.001) were independently associated with pain severity score.
CONCLUSIONS
Pain is a highly prevalent symptom among HD patients in Palestine. Subpopulations with higher pain severity include females, patients with higher BMI, and those with multiple comorbidities. Healthcare providers should routinely assess pain in HD patients as it is considered a significant concern. This would involve pain assessment and development of a treatment plan to improve clinical outcomes. The nephrology associations should also push for pain management in HD patients as a clinical and research priority to improve pain-related disability.
背景
慢性肾脏病（CKD）是全球日益严重的医学问题。终末期肾病（ESKD）是 CKD 阶段的最后阶段，需要肾脏替代治疗（RRT），如血液透析（HD），这似乎是最常用的类型。然而，与接受肾移植的患者相比，接受 HD 的患者仍然面临较高的死亡率和发病率。因此，我们旨在本研究中评估 HD 患者的疼痛患病率，并探讨与该主诉相关的因素。
方法
我们于 2018 年 8 月至 11 月在巴勒斯坦西岸进行了一项多中心横断面研究。我们使用基于问卷的直接访谈对受试者进行了访谈。在回顾了该领域的先前研究后，我们开发了我们的问卷，并纳入了患者的社会、人口和临床特征的项目，包括透析相关数据。它还包含简要疼痛问卷（BPI），以评估疼痛症状的不同方面。采用便利抽样技术收集数据。
结果
在 300 名参与者中，66.3%报告有慢性疼痛。HD 治疗本身是最常被提及的疼痛原因（21.6%）。最常被提及的疼痛部位是上下肢（37.3%）。对乙酰氨基酚是最常被用于缓解疼痛的药物治疗。多变量回归分析显示，BMI（p=0.018）、性别（p=0.023）和合并症数量（p<0.001）与疼痛严重程度评分独立相关。
结论
疼痛是巴勒斯坦 HD 患者中高度普遍的症状。疼痛严重程度较高的亚群包括女性、BMI 较高的患者和合并症较多的患者。医疗保健提供者应常规评估 HD 患者的疼痛，因为这被认为是一个重要问题。这将包括疼痛评估和制定治疗计划以改善临床结果。肾脏病协会还应将 HD 患者的疼痛管理作为临床和研究重点，以改善与疼痛相关的残疾。
Zotero 插件