[The evaluation and analysis of chronic pain in chronic hemodialysis patients]

Pain is a sensorial experience and emotional discomfort associated with a potential tissue damage or described in terms evoking such injuries. Its management is a task for every physician. However, the epidemiology and characteristics of pain among chronic hemodialysis patients are incompletely defined. PURPOSE OF OUR STUDY: To evaluate the prevalence, characteristics, impact and treatment of chronic pain in chronic hemodialysis and its potential risk factors.

A cross-sectional study included 67 chronic hemodialysis patients in the Ibn Sina Hospital hemodialysis center in Rabat. We evaluated the sociodemographic characteristics of patients and pain features, as well as the response to analgesics. Pain is described as chronic when it persists for more than 3 months. The pain intensity was specified by a verbal scale.

The mean age of our patients was 43.5+/-12.9 years with a feminine predominance (58.2%). The prevalence of pain was 50.7%. The pain was noticed for a mean period of 21 months (six to 60). This pain was continuous, frequent, intermittent and rare in respectively 20.6, 17.6, 47.1 and 14.7% of cases. The intensity of the pain was low in 3%, moderate in 41%, severe in 44% and very severe in 12% of cases. An osteoarticular origin was found in 76.5% of cases. A physical activity disorder was found in 67.6% of cases. Half of our patients were taking analgesics in 23.5% of cases, as daily use in 29.7% of cases frequently, and in 47.1% of cases rarely. These analgesics were level 1 in 47.1% and level 2 in 52.9% of cases. The therapeutic response is characterized by the disappearance of pain in 35.5% of cases. During dialysis sessions, pain intensity was the same in 79.4% of the patients. The risk factors associated with pain were an advanced age and a long length of time on dialysis.

A systematic evaluation of pain is required to improve the quality of life of hemodialysis patients.