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Pharmacologic Considerations for Opioid Use in Kidney Disease
Chelsea E Hawley1, Erin Hickey2, Laura K Triantafylidis3
1New England Geriatric Research, Education and Clinical Center, VA Boston Healthcare System, Boston, MA.
Seminars in Nephrology
|April 26, 2021
Summary
Individuals with kidney disease often receive opioid prescriptions for chronic pain, despite increased risks. This review explores safe opioid management strategies considering kidney disease and aging effects.
Area of Science:
- Nephrology
- Pharmacology
- Pain Management
Background:
- Chronic noncancer pain is prevalent in individuals with kidney disease.
- Opioids are frequently prescribed for this population, unlike the general population.
- Kidney disease, aging, and opioid pharmacology increase adverse event risk.
Purpose of the Study:
- To review the pharmacologic challenges of opioid use in kidney disease.
- To examine the impact of kidney disease and aging on opioid management.
- To support safe opioid prescribing practices for patients with kidney disease.
Main Methods:
- Literature review focusing on opioid pharmacology.
- Analysis of physiological changes in kidney disease and aging.
- Synthesis of information to guide clinical practice.
Main Results:
- Kidney disease alters opioid metabolism and excretion.
- Aging further complicates opioid pharmacokinetics and pharmacodynamics.
- Lack of specific guidelines for opioid management in this population.
Conclusions:
- Understanding opioid pharmacology and physiology is crucial for safe management.
- Tailored approaches are needed for patients with kidney disease requiring opioids.
- Further research and guideline development are warranted.
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