Caracterización del dolor en el paciente en hemodiálisis

Pozo, Mercedes Gómez; Parrado, María del Carmen Ruiz; Garrido, María Crespo; López, Victoria Eugenia Gómez; Montero, Rodolfo Crespo

doi:10.4321/s2254-28842017000400003

Cited by 6 publications

(5 citation statements)

References 9 publications

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“…Of these, 152 studies were excluded leaving 68 studies for inclusion in the analysis. 2,3,5,7,8,14,19,24-84 The flow chart in Figure 1 outlines this process, including reasons for exclusion. Supplemental Table S1 provides a list of excluded studies with reasons for exclusion.…”

Section: Resultsmentioning

confidence: 99%

“…Details of the 68 included studies are reported in Table 2 and include data from 16 558 patients from 26 countries. Forty-eight of the studies examined 8464 hemodialysis (HD) patients from 23 countries, 5,7,8,14,24,28,29,32,34-41,43-46,49,51-56,58,59,61-63,65-68,70,72,73,75,76,78-84 3 studies from 3 countries included data from 679 peritoneal dialysis (PD) patients, 24,49,81 and 8 studies from 6 countries reported data from 3701 patients on either HD or PD (without separating treatment groups). 2,3,25,26,60,69,71,77 Two studies assessed 112 patients from Canada and the United States following the withdrawal of dialysis.…”

Section: Resultsmentioning

confidence: 99%

“…35,41,52 Two studies defined pain at the withdrawal of dialysis, or in the last 24 hours of life following the withdrawal of dialysis. 19,33 Other definitions of chronic pain ranged from pain in the past 24 hours in 1 study, 67 a duration of pain of 3 days in 1 study, 74 7 days in 20 studies, 3,7,14,28,30,32,34,44,47,48,59,60,62,63,70,71,75,76,78,79 2 weeks in 1 study, 50 4 weeks in 12 studies, 8,25-27,37,49,65,68,69,72,77,84 6 weeks in 1 study, 56 3 months in 11 studies, 29,31,36,38-40,42,45,64,73,83 and “lasting weeks, months, or even years” in 1 study. 57 Fifteen studies did not specify a duration, despite the intent to understand chronic pain burden.…”

Section: Resultsmentioning

confidence: 99%

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The Prevalence and Severity of Chronic Pain in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Rathwell

Ghosh

George

et al. 2021

Can J Kidney Health Dis

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Background: Chronic pain is a common and distressing symptom reported by patients with chronic kidney disease (CKD). Clinical practice and research in this area do not appear to be advancing sufficiently to address the issue of chronic pain management in patients with CKD. Objectives: To determine the prevalence and severity of chronic pain in patients with CKD. Design: Systematic review and meta-analysis. Setting: Interventional and observational studies presenting data from 2000 or later. Exclusion criteria included acute kidney injury or studies that limited the study population to a specific cause, symptom, and/or comorbidity. Patients: Adults with glomerular filtration rate (GFR) category 3 to 5 CKD including dialysis patients and those managed conservatively without dialysis. Measurements: Data extracted included title, first author, design, country, year of data collection, publication year, mean age, stage of CKD, prevalence of pain, and severity of pain. Methods: Databases searched included MEDLINE, CINAHL, EMBASE, and Cochrane Library, last searched on February 3, 2020. Two reviewers independently screened all titles and abstracts, assessed potentially relevant articles, and extracted data. We estimated pooled prevalence of overall chronic pain, musculoskeletal pain, bone/joint pain, muscle pain/soreness, and neuropathic pain and the I2 statistic was computed to measure heterogeneity. Random effects models were used to account for variations in study design and sample populations and a double arcsine transformation was used in the model calculations to account for potential overweighting of studies reporting either very high or very low prevalence measurements. Pain severity scores were calibrated to a score out of 10, to compare across studies. Weighted mean severity scores and 95% confidence intervals were reported. Results: Sixty-eight studies representing 16 558 patients from 26 countries were included. The mean prevalence of chronic pain in hemodialysis patients was 60.5%, and the mean prevalence of moderate or severe pain was 43.6%. Although limited, pain prevalence data for peritoneal dialysis patients (35.9%), those managed conservatively without dialysis (59.8%), those following withdrawal of dialysis (39.2%), and patients with earlier GFR category of CKD (61.2%) suggest similarly high prevalence rates. Limitations: Studies lacked a consistent approach to defining the chronicity and nature of pain. There was also variability in the measures used to determine pain severity, limiting the ability to compare findings across populations. Furthermore, most studies reported mean severity scores for the entire cohort, rather than reporting the prevalence (numerator and denominator) for each of the pain severity categories (mild, moderate, and severe). Mean severity scores for a population do not allow for “responder analyses” nor allow for an understanding of clinically relevant pain. Conclusions: Chronic pain is common and often severe across diverse CKD populations providing a strong imperative to establish chronic pain management as a clinical and research priority. Future research needs to move toward a better understanding of the determinants of chronic pain and to evaluating the effectiveness of pain management strategies with particular attention to the patient outcomes such as overall symptom burden, physical function, and quality of life. The current variability in the outcome measures used to assess pain limits the ability to pool data or make comparisons among studies, which will hinder future evaluations of the efficacy and effectiveness of treatments. Recommendations for measuring and reporting pain in future CKD studies are provided. Trial registration: PROSPERO Registration number CRD42020166965

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The Prevalence and Severity of Chronic Pain in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Rathwell

Ghosh

George

et al. 2021

Can J Kidney Health Dis

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“…Intradialytic pain was predominantly localized in the lower limbs (18.7%) and the lower back area (18.7%). Studies have shown higher percentages of pain in the lower limbs: around 60% in the study by Santos et al [ 17 ], 42.3% in the study by Sousa et al [ 31 ], and 47% in the study by Pozo et al [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Pain Assessment in Patients during Hemodialysis Treatment: Quality Improvement Project

Rodrigues,

Costeira

2024

Nursing Reports

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Pain is a prevalent symptom in patients with chronic kidney disease, related to disease progression, comorbidities, and required immobility during dialysis treatment. Nurses must perform detailed pain assessments to manage pain effectively during hemodialysis treatment. This quality improvement project, reported using SQUIRE 2.0, aims to describe pain characteristics in chronic kidney disease patients in a hemodialysis unit clinic in Portugal, implement strategies to improve the pain assessment process in patients with chronic kidney disease during hemodialysis treatment, and assess nurses’ satisfaction with the implemented strategies. The study was conducted in a Portuguese hemodialysis clinic, with patients and nurses, in three phases: diagnostic study, protocol implementation, and a descriptive study to assess nurse satisfaction. Seventy-five patients (mean age 71 ± 12.6 years) participated, with 64% reporting moderate chronic pain daily and 48% during hemodialysis treatment. Thirteen nurses considered the pain assessment protocol important, rating their satisfaction at 7.92 ± 1.32 (0–10). Standardizing practices through protocol implementation is likely to improve care and increase nurse satisfaction.

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“…Según el Registro de la Sociedad Española de Nefrología de 2016, la prevalencia global de la ERCA en España es de 1233,5 pacientes por millón de población, de los cuales el 42.2% está en programa de Hemodiálisis (HD). A esto hay que añadir, que más del 60% son mayores de 65 años (10).…”

Section: Introductionunclassified

Complicaciones Por Hemodiálisis en Un Hospital De La Ciudad Machala, Ecuador

Rueda

Maldonado²,

Tamay³

et al. 2021

Enferm. investig.

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Introducción: La hemodiálisis constituye un tipo de terapia renal sustitutiva, indicado en los pacientes con Enfermedad renal crónica (ERC). Estas constituyen un problema de salud pública, afectando al 10% de la población adulta. Producto de enfermedades crónicas no transmisibles (ECNT) como la hipertensión arterial (HTA) o la diabetes mellitus (DM) entre otros. Objetivo: Identificar las complicaciones durante el tratamiento de hemodiálisis en pacientes con ERC. Métodos: Estudio descriptivo, transversal, muestra de 57 pacientes, mayores de 30 años; Se utilizó un cuestionario validado para recoger la información. Resultados: Los pacientes con hemodiálisis son mayores de 61 años en 33% de los casos; del género masculino en 51%. Con hemodiálisis por más de 19 meses el 72%. Complicados vértigos 47% de los casos, un 30% sin complicaciones y con un 5% hipertermia y taquipnea respectivamente. Con comorbilidades combinadas como diabetes+HTA+glomerulonefritis en un 19%; HTA+glomerulonefritis 18% y aisladamente glomerulonefritis en un 16%. Conclusiones: Existe un predominio del sexo masculino, mayores de 61 años en pacientes que reciben hemodiálisis. Con comorbilidades combinadas como glomerulonefritis con hipertensión arterial y diabetes. Seguido de la combinación glomerulonefritis con hipertensión arterial y en tercer lugar glomerulonefritis aislada. Observándose que el factor común es la glomerulonefritis. La complicación más frecuente fue el vértigo, seguido de ninguna complicación en casi el tercio de la muestra estudiada, un pequeño porcentaje presentó taquipnea, epistaxis, aisladas o combinadas. La socialización del autocuidado en pacientes con diabetes e HTA para evitar el desarrollo de la Enfermedad renal crónica, es la clave para su prevención Palabras clave: hemodiálisis, terapia renal sustitutiva, enfermedad renal crónica ABSTRACT Introduction: Hemodialysis is a type of renal replacement therapy, indicated in patients with chronic kidney disease (CKD). These constitute a public health problem, affecting 10% of the adult population. Product of chronic non-communicable diseases (CNCD) such as arterial hypertension (HT) or diabetes mellitus (DM) among others. Aim: Identify complications during hemodialysis treatment in CKD patients. Methods: Descriptive, cross-sectional study, sample of 57 patients, older than 30 years; A validated questionnaire was carried out to collect the information. Results: Hemodialysis patients are older than 61 years in 33% of cases; of the masculine gender in 51%. With hemodialysis for more than 19 months, 72%. Complicated vertigo in 47% of cases, 30% without complications and with 5% hyperthermia and tachypnea respectively. With combined comorbidities such as diabetes + hypertension + glomerulonephritis in 19%; HBP + glomerulonephritis in 18% and glomerulonephritis in isolation in 16%. Conclusions: There is a predominance of males, older than 61 years in patients receiving hemodialysis. With combined comorbidities such as glomerulonephritis with high blood pressure and diabetes. Followed by the combination of glomerulonephritis with arterial hypertension and thirdly isolated glomerulonephritis. Noting that the common factor is glomerulonephritis. The most frequent complication was vertigo, followed by no complication in almost a third of the sample studied, a small percentage presented tachypnea, epistaxis, isolated or combined. The socialization of self-care in patients with diabetes and hypertension to avoid the development of chronic kidney disease is the key to its prevention Key words: hemodialysis, renal replacement therapy, chronic kidney disease

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Caracterización del dolor en el paciente en hemodiálisis

Cited by 6 publications

References 9 publications

The Prevalence and Severity of Chronic Pain in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis

The Prevalence and Severity of Chronic Pain in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Pain Assessment in Patients during Hemodialysis Treatment: Quality Improvement Project

Complicaciones Por Hemodiálisis en Un Hospital De La Ciudad Machala, Ecuador

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