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Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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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.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|January 27, 2021
PubMed
Summary
This summary is machine-generated.

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.

Keywords:
Chronic painanalgesic ladderbuprenorphinechronic kidney disease (CKD)fentanylhydromorphonemethadoneopioidopioid use disorder (OUD)oxycodonepain managementpalliative carereview

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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.