Pharmacotherapeutic Management of Neuropathic Pain in End-Stage Renal Disease.

Kidney Diseases
Mena RaoufJeffrey J Fudin

Abstract

Chronic noncancer pain is pervasive throughout the general patient population, transcending all chronic disease states. Patients with end-stage renal disease (ESRD) present a complicated population for which medication management requires careful consideration of the pathogenesis of ESRD and intimate knowledge of pharmacology. The origin of pain must also guide treatment options. As such, the presentation of neuropathic pain in ESRD can present a challenging case. The authors aim to provide a review of available classes of medications and considerations for the treatment of neuropathic pain in ESRD. In this narrative review, the authors discuss important strategies and considerations for the treatment of neuropathic pain in ESRD, including the pathogenesis of neuropathic pain, physiological changes for consideration in ESRD patients, and disease-specific consideration for medication selection. Pharmacotherapeutic classes discussed include: anticonvulsants, antiarrhythmics, antidepressants, topicals, and opioids. Pain management in ESRD patients requires careful assessment of drug-specific properties, accumulation, metabolism (presence of active/toxic metabolites), extraction by dialysis, and presence of drug - drug interactions...Continue Reading

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Sep 29, 2020·Therapeutics and Clinical Risk Management·Flaminia ColuzziPatrizia Romualdi
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Jan 18, 2022·The International Journal of Lower Extremity Wounds·Nathalie Schembri, Cynthia Formosa

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