An analysis to be published in the Clinical Journal of the American Society of Nephrology concludes that patients receiving hemodialysis for kidney failure should limit their use of opioid analgesics for the management of pain, a commonly reported accompanying effect of this treatment. The analysis, conducted by researchers from the University of California, San Francisco and San Francisco VA Medical Center, examined patient records from 140,899 adults covered by Medicare who were undergoing in-center hemodialysis during 2011. Median age of participants was 61 years, and 52% were men. 64% of the group received a prescription for opioids during the study period, and instances for altered mental state, falls, and fractures requiring in-hospital attention were found to occur in 11%, 5% and 3% of this cohort, respectively.
Study author Julie Ishida, MD, MAS, commented, “Opioid use in patients receiving hemodialysis, even at lower dosing, is not without risk, and the balance of risks and benefits in this population should be carefully considered. Future research and strategies to predict and reduce the risks of opioid use in patients receiving hemodialysis are needed.” Dr. Ishida noted that the increased risk was observed even among patients not taking high doses of opioids, and included patients taking only opioids that have been recommended for the management of hemodialysis related pain. This suggests that presently-existing guidelines for pain management in this population should be re-examined.
Read a news story about the findings and recommendations.
The journal abstract may be read here.
Posted on April 23, 2018