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Opioids and renal function.

Sebastiano Mercadante1, Edoardo Arcuri

  • 1Pain Relief and Palliative Care Unit, La Maddalena Cancer Center, Palermo, Italy. terapiadeldolore@la-maddalena.it

The Journal of Pain
|February 21, 2004
PubMed
Summary

Opioids significantly impact kidney function, affecting water and sodium excretion. Understanding this relationship is crucial for safe opioid use, especially in patients with impaired renal function.

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Area of Science:

  • Pharmacology
  • Nephrology
  • Renal Physiology

Background:

  • Opioids, both internal and external, significantly affect kidney function through various mechanisms, altering water and sodium excretion.
  • Different opioid receptor agonists (mu, kappa, delta) elicit distinct renal responses, though underlying mechanisms require further elucidation.

Purpose of the Study:

  • To review the influence of renal function on the clinical use of different opioids.
  • To discuss challenges related to opioid use in patients with kidney issues, including transplantation and opioid-induced renal damage.

Main Methods:

  • Review of experimental data and existing literature on opioid-renal interactions.
  • Analysis of clinical implications for pain management and adverse effect mitigation.

Main Results:

  • Opioid administration influences renal excretion of water and sodium.
  • Kappa agonists show potential therapeutic applications for fluid retention in conditions like hepatic cirrhosis.
  • Renal impairment critically affects the clearance of commonly used opioids.

Conclusions:

  • Endogenous opioids play a physiological role in renal function; exogenous opioid use impacts renal activity.
  • Close biochemical and clinical monitoring is essential to prevent severe complications in patients using opioids with renal impairment.

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