A stepwise approach for effective management of chronic pain in autosomal-dominant polycystic kidney disease

Niek F Casteleijn; Folkert W Visser; Joost P H Drenth; Tom J G Gevers; Gerbrand J Groen; Marie C Hogan; Ron T Gansevoort; DIPAK Consortium

doi:10.1093/ndt/gfu073

A stepwise approach for effective management of chronic pain in autosomal-dominant polycystic kidney disease

Nephrol Dial Transplant. 2014 Sep;29 Suppl 4(Suppl 4):iv142-53. doi: 10.1093/ndt/gfu073.

Authors

Niek F Casteleijn¹, Folkert W Visser¹, Joost P H Drenth², Tom J G Gevers², Gerbrand J Groen³, Marie C Hogan⁴, Ron T Gansevoort¹; DIPAK Consortium

Collaborators

DIPAK Consortium:
J P H Drenth, J W de Fijter, R T Gansevoort, D J M Peters, J Wetzels, R Zietse

Affiliations

¹ Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
² Department of Gastroenterology and Hepatology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands.
³ Pain Centre, Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
⁴ Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.

Abstract

Chronic pain, defined as pain existing for >4-6 weeks, affects >60% of patients with autosomal-dominant polycystic disease (ADPKD). It can have various causes, indirectly or directly related to the increase in kidney and liver volume in these patients. Chronic pain in ADPKD patients is often severe, impacting physical activity and social relationships, and frequently difficult to manage. This review provides an overview of pathophysiological mechanisms that can lead to pain and discusses the sensory innervation of the kidneys and the upper abdominal organs, including the liver. In addition, the results of a systematic literature search of ADPKD-specific treatment options are presented. Based on pathophysiological knowledge and evidence derived from the literature an argumentative stepwise approach for effective management of chronic pain in ADPKD is proposed.

Keywords: ADPKD; management; pain; polycystic kidney disease; polycystic liver disease.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Chronic Pain / etiology
Chronic Pain / prevention & control*
Disease Management
Humans
Polycystic Kidney, Autosomal Dominant / complications*