Pain determinants of pain in autosomal dominant polycystic kidney disease

Nishiura, José Luiz; Eloi, Samara Rodrigues Moreira; Heilberg, Ita Pfeferman

doi:10.5935/0101-2800.20130038

Cited by 9 publications

(6 citation statements)

References 5 publications

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“…Limited research examining the initial phase of ADPKD prior to the development of chronic kidney disease (CKD) has been published; however, there is growing evidence to suggest that patients can suffer symptoms, such as pain and fatigue, during the early stage of their disease [ 10 , 11 ]. Back pain is the most common factor leading to ADPKD diagnosis, often experienced by patients in early disease with normal renal function [ 10 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

Understanding the physical and emotional impact of early-stage ADPKD: experiences and perspectives of patients and physicians

et al. 2015

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BackgroundAutosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disorder; however, at the time this research was conducted, no disease-modifying treatment was currently available. Medical texts often describe early-stage disease (Stages 1 and 2) as asymptomatic, but there is evidence from patients of considerable physical and emotional effects.MethodsIn-depth interviews were conducted with 80 ADPKD patients, 72 nephrologists and 85 primary care physicians (PCPs) from nine European countries to explore the experience and impact of early-stage ADPKD. Interviews were transcribed, translated and analysed centrally using thematic analysis. An additional 600 physicians completed standardised online questionnaires to investigate perceptions of symptom severity and management of early-stage ADPKD.ResultsEighty-eight per cent of patients with early-stage disease reported physical symptoms including pain, fatigue, breathlessness, weakness and a general malaise. However, 24% of nephrologists and 16% of PCPs perceived that the patients with early-stage disease did not experience any physical symptoms at all. There was a greater awareness of the emotional impact of disease, but this was still underestimated when compared with patient-reported experiences, which highlighted widespread feelings of loss, uncertainty and fear.Patients and physicians experienced frustration due to the lack of treatment options, especially in the long latent period. For many patients, the inability to affect their disease course whilst living with a diagnosis resulted in feelings of hopelessness, helplessness and depression. Physicians identified a need for improved cooperation between health-care professionals, and increased psychological support for patients.ConclusionsEarly-stage ADPKD can have a significant physical and emotional impact on patients. Whilst some physicians have an awareness of patient experience during early-stage disease, most underestimate the impact of ADPKD. Both patients and physicians are negatively affected by their inability to alter disease progression.

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Section: Introductionmentioning

confidence: 99%

Understanding the physical and emotional impact of early-stage ADPKD: experiences and perspectives of patients and physicians

et al. 2015

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“…Kidney stones in patients with ADPKD are associated with significant pain and morbidity. 12 In the chronic kidney disease population, patients with stones are at higher risk of end-stage kidney disease compared with patients without stones, with the suggestion that this is also true in patients with ADPKD. 13,14 For these reasons, stones should be optimally managed in patients with ADPKD.…”

Section: Introductionmentioning

confidence: 99%

Risk of Hospital Encounters With Kidney Stones in Autosomal Dominant Polycystic Kidney Disease: A Cohort Study

Kalatharan

Welk

Nash

et al. 2021

Can J Kidney Health Dis

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Background: There is a perception that patients with autosomal dominant polycystic kidney disease (ADPKD) are more likely to develop kidney stones than the general population. Objective: To compare the rate of hospital encounter with kidney stones and the rate of stone interventions between patients with and without ADPKD. Design: Retrospective cohort study. Setting: Ontario, Canada. Patients: Patients with and without ADPKD who had a prior hospital encounter between 2002 and 2016. Measurements: Rate of hospital encounter with kidney stones and rate of stone intervention. Methods: We used inverse probability exposure weighting based on propensity scores to balance baseline indicators of health between patients with and without ADPKD. We followed each patient until death, emigration, outcomes, or March 31, 2017. We used a Cox proportional hazards model to compare event rates between the two groups. Results: Patients with ADPKD were at higher risk of hospital encounter with stones compared with patients without ADPKD (81 patients of 2094 with ADPKD [3.8%] vs 60 patients of 1902 without ADPKD [3.2%]; 8.9 vs 5.1 events per 1000 person-years; hazard ratio 1.6 [95% CI, 1.3-2.1]). ADPKD was not associated with a higher risk of stone intervention (49 of 2094 [2.3%] vs 47 of 1902 [2.4%]; 5.3 vs 3.9 events per 1000 person-years; hazard ratio 1.2 [95% CI = 0.9-1.3]). Limitations: We did not have information on kidney stone events outside of the hospital. There is a possibility of residual confounding. Conclusion: ADPKD was a significant risk factor for hospital encounters with kidney stones.

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“…For example, stones are a significant determinant of pain and may accelerate disease progression to ESKD in patients with ADPKD. 13,14 We conducted this systematic review to critically appraise and summarize studies which reported the incidence and prevalence of kidney stones and stone interventions in patients with ADPKD. This encompassed studies which also included patients without ADPKD as a comparator.…”

Section: Introductionmentioning

confidence: 99%

“…For example, stones are a significant determinant of pain and may accelerate disease progression to ESKD in patients with ADPKD. 13 , 14 …”

Section: Introductionmentioning

confidence: 99%

Stone Prevalence in Autosomal Dominant Polycystic Kidney Disease: A Systematic Review and Meta-Analysis

Kalatharan

Grewal

Nash

et al. 2020

Can J Kidney Health Dis

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Background: It is uncertain how often patients with autosomal dominant polycystic kidney disease (ADPKD) develop kidney stones. Objective: To review English-language studies reporting the incidence and prevalence of stones and stone interventions in adults with ADPKD. Design: Systematic review and meta-analysis. Setting: Any country of origin. Patients: Adult patients with ADPKD. Measurements: Incidence or prevalence of kidney stones and stone interventions. Methods: We reviewed 1812 citations from bibliographic databases, abstracted data from 49 eligible studies, and assessed methodological quality in duplicate. In some studies, the proportion of adults with ADPKD with the outcome were compared to adults without ADPKD; for these studies, prevalence risk ratios were calculated and pooled using a random effects model. Results: We identified 49 articles that met our review criteria. The methodological quality of many studies was limited (scores ranging from 2 to 14 out of 22, with a higher score indicating higher quality). No study clearly reported stone incidence, and in the cross-sectional studies, the definition of stones was often unclear. The prevalence of stones ranged from 3% to 59%, and a prevalence of stone interventions ranged from 1% to 8%; the average patient age at the time of assessment ranged from 26 to 61 years across the studies. Two studies reported a nonstatistically significant higher stone prevalence in patients with ADPKD compared to unaffected family members. Compared to unaffected family members, patients with ADPKD had a higher prevalence of kidney stones (6 cross-sectional studies; unadjusted prevalence ratio: 1.8; 95% confidence interval: 1.3 to 2.6; P = .0007; test for heterogeneity: I2 = 0%, P = .8). Limitations: Studies were limited to articles published in English. Conclusions: The prevalence of kidney stones and stone interventions in adults with ADPKD remains uncertain. Future studies of higher methodological quality are needed to better characterize the incidence and prevalence of kidney stones in patients with ADPKD. Trial registration: We did not register the protocol for this systematic review.

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Pain determinants of pain in autosomal dominant polycystic kidney disease

Cited by 9 publications

References 5 publications

Understanding the physical and emotional impact of early-stage ADPKD: experiences and perspectives of patients and physicians

Understanding the physical and emotional impact of early-stage ADPKD: experiences and perspectives of patients and physicians

Risk of Hospital Encounters With Kidney Stones in Autosomal Dominant Polycystic Kidney Disease: A Cohort Study

Stone Prevalence in Autosomal Dominant Polycystic Kidney Disease: A Systematic Review and Meta-Analysis

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