Pain in Patients With Chronic Kidney Disease Undergoing Hemodialysis: A Systematic Review

Pain Manag Nurs. 2021 Oct;22(5):605-615. doi: 10.1016/j.pmn.2021.05.009. Epub 2021 Jun 30.

Abstract

Aims: To assess the presence of pain, its location, intensity, and effects on the daily activities of patients with chronic kidney disease (CKD) undergoing hemodialysis (HD).

Participants/subjects: Patients with chronic kidney disease (CKD) undergoing hemodialysis (HD).

Design: A systematic review.

Methods: We carried out search for articles published until December 2020, including publications in Portuguese, English, and Spanish during the past 15 years (2005-2020), using the Embase, SciELO, PubMed, and Web of Science databases. The following information was collected: type of pain, pain treatment, pain assessment instrument, prevalence of pain, location, and influence of pain on quality of life.

Results: Twenty-five studies were selected for a systematic review. These studies involved a total of 98,162 adult and elderly patients with CKD who were undergoing HD. There was a high prevalence of pain in patients with CKD on HD. The most frequent sites of pain were the head, back, bones, chest, and the upper and lower limbs. The presence of acute, chronic, neuropathic pain, and myalgia was also reported in the studies. In addition, there was a higher frequency of moderate and severe pain, which influenced daily activities, the ability to walk, mood, relationships with other people, sleep, and work in patients on dialysis.

Conclusions: The analyzed studies suggest that acute and chronic pain is a prevalent complaint in adults and elderly patients undergoing HD. There was a higher frequency of moderate and severe pain in different parts of the body, and pain interfered with everyday activities.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Chronic Pain*
  • Humans
  • Pain Measurement
  • Quality of Life
  • Renal Dialysis / adverse effects
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / therapy