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Opioid Management in CKD
Emily Lu1, Jane O Schell2, Holly M Koncicki1
1Division of Nephrology and Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Summary
This article offers a stepwise approach for managing pain in chronic kidney disease (CKD) patients using opioids. It guides nephrologists through individualized assessment and risk reduction strategies for safe opioid use.
Area of Science:
- Nephrology
- Pain Management
- Pharmacology
Background:
- Patients with chronic kidney disease (CKD) face significant pain and symptom burden.
- Opioid prescription and use are increasing in CKD patients, raising safety concerns.
Purpose of the Study:
- To provide nephrologists with an evidence-based, stepwise approach for assessing and managing pain in CKD patients.
- To address challenges in pain management for nephrologists lacking specialized training.
Main Methods:
- The article proposes a sequential approach to opioid management in CKD.
- It emphasizes thorough evaluation of pain, opioid history, and treatment goals.
- Key considerations for initiating opioid therapy and risk reduction are discussed.
Main Results:
- The approach facilitates individualized opioid assessment tailored to kidney-specific concerns.
- It outlines strategies for reducing opioid-related risks in CKD patients.
- Best practices for opioid stewardship in CKD are recommended.
Conclusions:
- This stepwise approach equips nephrologists with tools for effective pain management in CKD.
- It promotes a comprehensive understanding of opioid implications and patient-tailored therapy.
- The strategy aims to improve opioid use and stewardship in the CKD population.
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