The Prevalence and Severity of Chronic Pain in Patients with End-Stage Kidney Disease (ESKD) on Maintenance Hemodialysis

Yahya Azeem Ahmad; Misbah Rehman; Zarwa Shahid; Muhammad Irfan Jamil; Iqra Naeem; Ghulam Abbas

doi:10.70749/ijbr.v3i2.1938

Authors

Yahya Azeem Ahmad Department of Nephrology, Nishtar Hospital, Multan, Punjab, Pakistan.
Misbah Rehman Department of Nephrology, Nishtar Hospital, Multan, Punjab, Pakistan.
Zarwa Shahid Department of Nephrology, Nishtar Hospital, Multan, Punjab, Pakistan.
Muhammad Irfan Jamil Department of Nephrology, Lahore General Hospital, Lahore, Punjab, Pakistan.
Iqra Naeem Department of Psychiatry, Lahore General Hospital, Lahore, Punjab, Pakistan.
Ghulam Abbas Department of Nephrology, Nishtar Hospital, Multan, Punjab, Pakistan

DOI:

https://doi.org/10.70749/ijbr.v3i2.1938

Keywords:

Chronic Pain, End-stage Kidney Disease, Hemodialysis, Pain Assessment

Abstract

Background and Aim: Chronic pain is a common yet often underrecognized symptom in patients with end-stage kidney disease (ESKD) receiving maintenance hemodialysis. This study was conducted to determine the prevalence, severity, and associated clinical and biochemical factors of chronic pain in patients undergoing long-term hemodialysis at a tertiary care center in Multan, Pakistan. Materials and Methods: A descriptive cross-sectional study was conducted over six months (February 2024 to August 2024) at the dialysis units of Nishtar Hospital, Multan. A total of 150 adult ESKD patients on maintenance hemodialysis were enrolled using non-probability consecutive sampling. Data on demographics, comorbidities, dialysis duration, and laboratory parameters were collected. Chronic pain was defined as pain lasting ≥3 months and graded by the Numerical Rating Scale. Statistical associations were assessed using chi-square and independent sample t-tests. Results: Among 150 patients (mean age 52.4 ± 13.2 years; 58% male), 98 (65.3%) reported chronic pain. Of these, 28 (28.6%) had mild, 41 (41.8%) moderate, and 29 (29.6%) severe pain. Common pain sites included the lower back (34.7%) and lower limbs (26.5%). Chronic pain was more prevalent among females (74.6%, p = 0.034), diabetics (78.7%, p < 0.001), and patients with dialysis duration >24 months (79.8%, p < 0.001). Lower hemoglobin (p = 0.004), lower ferritin (p = 0.012), higher calcium-phosphate product (p = 0.007), and elevated iPTH levels (p = 0.003) were significantly associated with chronic pain. Conclusion: Chronic pain affects two-thirds of hemodialysis patients and is associated with demographic, clinical, and metabolic factors. Regular screening and targeted interventions should be integrated into dialysis care for symptom relief.

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