A study published recently in the Journal AJKD explored the relevance of pain with renal dysfunction and the development and risk of death of chronic kidney diseases. The results showed that moderate-severe pain can accelerate the rate of decline in kidney function, increasing risk of death.
The retrospective cohort study included 2,360,056 American veterans, nearly 60% of which had pain problems and common paregoric for them are opioid analgesics. The estimated baseline of glomerular filtration rate (eGFR) is ≥ 60 mL / min / 1.73 m2. Pain rating: None (0), mild (1-4 points) and severe (5-6), and severe (≥ 7 points). Endpoint: eGFR declines and incidence of eGFR <60 mL / min / 1.73 m2 or all-cause mortality.
After adjustment for baseline eGFR level, demographics, comorbidities, cardiovascular risk factors and depression, use Cox proportional hazards regression model with pain (1) eGFR decreased rapidly; (2) eGFR <60 mL / min / 1.73 m2 occurred or all-cause mortality rate correlation.
It was found that the risk of eGFR rapidly decline in patients with moderate and severe pain was much higher than that of those without pain or with mild pain. The ratio of patients with moderate pain was 1.11 (95% confidence interval 1.09-1.14); the radio of patients with severe pain was 1.17 (95% confidence interval 1.13-1.21). Patients with moderate and severe pain had the risk of eGFR <60 mL / min / 1.73 m2 or risk of death 30% higher than those without pain. The risk radio of patients with moderate pain was 1.30 (95% confidence interval 1.28-1.31), the risk ratio of patients with severe pain was 1.30 (95% confidence interval 1.28-1.32).
Although this study has several limitations (a lack of detailed data on the types of pain and pain location), it still shows that pain is associated with the increase of incidence rate of eGFR <60 mL / min / 1.73 m2, the speed of decline in renal function and mortality.
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