Opioid Management in CKD.
Am J Kidney Dis
; 77(5): 786-795, 2021 05.
Article
en En
| MEDLINE
| ID: mdl-33500128
ABSTRACT
Patients with chronic kidney disease (CKD) experience a high pain and symptom burden. Concurrently, opioid prescription and use in patients with CKD continues to increase, leading to concern for opioid-related risks. Nephrologists increasingly face challenging clinical situations requiring further evaluation and treatment of pain, for which opioid use may be indicated. However, nephrologists are not commonly trained in pain management and may find it difficult to compile the necessary information and tools to effectively assess and treat potentially multidimensional pain. In these situations, they may benefit from using an evidence-based stepwise approach proposed in this article. We address current approaches to opioid use for pain management in CKD and offer a stepwise approach to individualized opioid assessment, focusing on kidney-specific concerns. This includes thorough evaluation of the pain experience, opioid use history, and treatment goals. We subsequently discuss considerations when initiating opioid therapy, strategies to reduce opioid-related risks, and recommended best practices for opioid stewardship in CKD. Using this sequential approach to opioid management, nephrologists can thereby gain a broad overview of key patient considerations, the foundation for understanding implications of opioid use, and a patient-tailored plan for opioid therapy.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
/
8_ODS3_consumo_sustancias_psicoactivas
Problema de salud:
2_sustancias_psicoativas
/
8_opioid_abuse
Asunto principal:
Analgésicos no Narcóticos
/
Insuficiencia Renal Crónica
/
Dolor Crónico
/
Dolor Nociceptivo
/
Analgésicos Opioides
/
Neuralgia
Tipo de estudio:
Etiology_studies
/
Guideline
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Am J Kidney Dis
Año:
2021
Tipo del documento:
Article