A chronic pain as a result from an injury to the nervous system, known as Neuropathic Pain (NP), occurs commonly among persons who receive dialysis. It is estimated that 70% to 100% of dialysis patients will experience neuropathic symptoms despite reaching current targets for dialysis adequacy (Kt/V ≥ 1.2 ). The incidence of uremic neuropathy appears to be less in Chronic Kidney Disease (CKD) sufferers who are not receiving dialysis.
NP is often a chronic condition that is difficult to treat. The primary goal for most is to make their incurable pain "bearable" or "tolerable." Secondary treatment goals are to improve sleep, the ability to function, and overall quality of life. Because of the chronic nature of NP, it is important to recognize and treat underlying issues such as anxiety and depression.
Some reports suggest that non-pharmacological treatments such as exercise, electrical nerve stimulation, and cognitive behavioral therapy may offer modest relief from NP. The pharmacological treatment requires patience, time, personal education, and a team effort. For those receiving dialysis, the frequent contact with healthcare professionals can provide regular opportunities to assess pain and response to therapy.
In order to evaluate the effectiveness of any medication for NP, you can inform your doctor or nurse about pain intensity before and after the medication is started. It is important to control how much medication you take because being on dialysis you have to be concerned about dizziness and drowsiness. Medications should be added in sequence with adequate time for evaluating their individuals effectiveness and toxicity.
Patient education is critically important to the treatment of NP. Be aware that NP is a chronic condition that will never be cured, rather you can make it more tolerable with the appropriate treatment plan. Frequently, multiple medications or a combination of medications may be tried before achieving a reduction in pain, and because NP is chronic, it is likely that even if pain is reduced to a manageable level, you will continue to take the medications.
Treatment of Neuropathic Pain in Patients with Chronic Kidney Disease. Read Periodicals