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Resultados de un protocolo gradual multidisciplinario para el tratamiento del dolor refractario crónico relacionado
Paul Geertsema1, Ron T Gansevoort1, Benjamin H J Doornweerd2
1Department of Nephrology, Expertise Center for Polycystic Diseases, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
Journal of clinical medicine
|August 28, 2025
Resumen
Un protocolo multidisciplinario de control del dolor redujo efectivamente el dolor renal crónico en pacientes sin enfermedad renal poliquística autosómica dominante (ADPKD). Este tratamiento también redujo la dependencia de medicamentos para el dolor, mejorando la calidad de vida de las personas con dolor renal refractario.
Área de la Ciencia:
- Nefrología
- Tratamiento del dolor
- Urología
Sus antecedentes:
- El dolor crónico relacionado con los riñones afecta significativamente la calidad de vida del paciente.
- La enfermedad renal poliquística autosómica dominante (ADPKD, por sus siglas en inglés) es una causa común de dolor renal.
- El dolor renal no relacionado con la EADPK a menudo presenta desafíos en el manejo.
Objetivo del estudio:
- Evaluar un protocolo de tratamiento multidisciplinario para el dolor relacionado con los riñones en pacientes sin ADPKD.
- Evaluar la eficacia del protocolo para proporcionar un alivio sostenido del dolor.
- Para determinar el impacto en el uso de analgésicos y la calidad de vida.
Principales métodos:
- Serie de casos prospectivos de pacientes no afectados por ADPKD con dolor renal severo y refractario (VAS ≥50).
- El tratamiento gradual incluyó métodos no farmacológicos, analgésicos, aspiración/fenestración de quistes, bloqueos nerviosos y nefrectomía.
- Resultados del dolor medidos por la Escala Análoga Visual (EAV), dosis diaria de analgésicos y puntuaciones de calidad de vida.
Principales resultados:
- Se incluyeron 12 pacientes con una duración media del dolor de 1,9 años.
- Reducción significativa de la puntuación VAS de 70 a 35 (a corto plazo) y 40 (a largo plazo) (p < 0,01).
- Uso reducido de analgésicos opioides y no opioides en el seguimiento a corto y largo plazo (p<0,05).
Conclusiones:
- El protocolo multidisciplinario ofrece un alivio del dolor eficaz y sostenido para el dolor renal crónico y refractario no relacionado con la enfermedad de Parkinson.
- El protocolo reduce con éxito la necesidad de analgésicos en este grupo de pacientes.
- Este enfoque proporciona una opción de tratamiento viable para el dolor debilitante relacionado con los riñones más allá de la ADPKD.
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