Related Experiment Video

Updated: Jan 22, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

16.7K

Opioid Management in Older Adults with Chronic Kidney Disease: A Review

Montgomery T Owsiany1, Chelsea E Hawley2, Laura K Triantafylidis3

  • 1New England Geriatric Research, Education and Clinical Center.

The American Journal of Medicine
|July 12, 2019
PubMed

Insights

For older adults with chronic kidney disease (CKD), safe opioid use for chronic pain is crucial. Transdermal buprenorphine and fentanyl, plus oral hydromorphone, are recommended, while others require caution or avoidance.

Area of Science:

  • Nephrology
  • Geriatrics
  • Pain Management

Background:

  • Chronic pain is common in older adults with chronic kidney disease (CKD).
  • Reduced kidney function in aging CKD patients increases risks of drug accumulation and adverse events.
  • Opioid efficacy is emerging in CKD, but data for older, non-dialysis patients are limited.

Purpose of the Study:

  • To identify the safest oral and transdermal opioids for older adults with non-dialysis CKD.
  • To provide evidence-based recommendations for opioid management in this vulnerable population.

Main Methods:

  • Systematic review of existing literature on opioid use in older adults with non-dialysis CKD.
  • Analysis of pharmacokinetic and pharmacodynamic data relevant to impaired kidney function.
  • Evaluation of adverse event profiles for various oral and transdermal opioids.

Main Results:

  • Transdermal buprenorphine, transdermal fentanyl, and oral hydromorphone show the best tolerability.
  • Hydrocodone, oxycodone, and methadone are viable but necessitate close monitoring.
  • Tramadol, codeine, morphine, and meperidine should be avoided due to accumulation risks.

Conclusions:

  • Opioid selection requires careful consideration of kidney function and patient age.
  • Vigilant monitoring is essential to mitigate adverse events in older adults with CKD.
  • Interprofessional collaboration ensures safe and effective opioid prescribing for chronic pain.
Keywords:
AgingChronic kidney diseaseCollaborationNondialysisOlder adultsOpioidsPain management

More Related Videos

Dissection of the Adult Zebrafish Kidney07:40

Dissection of the Adult Zebrafish Kidney

Published on: August 29, 2011

37.6K
Analysis of Nephron Composition and Function in the Adult Zebrafish Kidney08:53

Analysis of Nephron Composition and Function in the Adult Zebrafish Kidney

Published on: August 9, 2014

45.4K

Related Concept Videos

Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
331
Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
597
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
578
Chronic Obstructive Pulmonary Disease-V: Management01:29

Chronic Obstructive Pulmonary Disease-V: Management

Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
3.1K
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
359
Chronic Obstructive Pulmonary Disease-V: Nursing Management01:30

Chronic Obstructive Pulmonary Disease-V: Nursing Management

Nursing management of Chronic Obstructive Pulmonary Disease (COPD) is crucial for providing thorough care and support to patients. Nurses play an integral role in this process through detailed assessment, careful planning, targeted interventions, and ongoing evaluation. Here's an overview of the critical steps in nursing management for COPD.
Assessment
5.1K