Pain, Sleep Disturbance and Survival in Hemodialysis Patients

Overview

Journal Nephrol Dial Transplant

Publisher Oxford University Press

Specialties General Surgery
Nephrology

Date 2011 Jul 21

PMID 21771748

Citations 29

Authors

Tara J Harris

Racha Nazir

Prashant Khetpal

Rolf A Peterson

Priyanka Chava

Samir S Patel

Paul L Kimmel

Affiliations

Soon will be listed here.

Abstract

Background: Patients' perception of pain during hemodialysis (HD) and at times between HD treatment and its association with survival have not been well studied in end-stage renal disease (ESRD). We evaluated the experience of pain during HD and at times when the patient was not receiving HD, and assessed possible associations of the perception of pain and sleep disturbance with patient survival.

Methods: A total of 128 ESRD patients treated with HD completed questionnaires on psychosocial status, quality of life and sleep disorders. A modified McGill Pain questionnaire was used to assess the nature, location, frequency, intensity and duration of pain both during and at times between HD sessions. The Pittsburgh Sleep Quality Index was used to screen for sleep disturbances over a 30-day period.

Results: Controlling for age, diabetes mellitus, serum albumin concentration and human immunodeficiency virus infection, there was a significant association between mortality and both frequency and intensity of pain while patients were not on HD. There was no association between survival and duration of pain while off HD or any of the pain parameters while patients were on HD. There was no association between survival and the presence of a sleep disorder.

Conclusions: Pain perception while off HD may be of more importance to patients than pain during HD. The mechanisms underlying the association are unknown but may involve linkage of pain with severity of medical illness or the generation of a maladaptive cytokine response. Multicenter prospective studies of pain interventions using well-validated pain perception tools are needed to establish causal relationships. Interventions directed toward treating pain on non-HD days may improve ESRD patient survival.

Citing Articles

Bio-sociological and clinical factors of chronic pain and pain interference in patients undergoing hemodialysis: a cross-sectional study.

Bouchachi F, Wachami N, Iderdar Y, Arraji M, Elgot A, Chahboune M BMC Nephrol. 2025; 26(1):83.

PMID: 39966760 PMC: 11834491. DOI: 10.1186/s12882-025-03987-7.

Patient-Reported Outcomes to Achieve Person-Centered Care for Aging People With Kidney Disease.

Lo C, Sheshadri A, Edmonson L, Nair D Semin Nephrol. 2024; 44(3-4):151548.

PMID: 39181804 PMC: 11456389. DOI: 10.1016/j.semnephrol.2024.151548.

Association between sleep quality and cardiovascular disease in maintenance hemodialysis patients: a prospective cohort study.

Tian H, Wang L, He Q, Xu X, Zhang Y, Yang J Ren Fail. 2023; 45(2):2278310.

PMID: 37936488 PMC: 10653692. DOI: 10.1080/0886022X.2023.2278310.

Depression in maintenance hemodialysis patients: What do we need to know?.

Li Y, Zhu B, Shen J, Miao L Heliyon. 2023; 9(9):e19383.

PMID: 37662812 PMC: 10472011. DOI: 10.1016/j.heliyon.2023.e19383.

Factors Affecting Pain in Hemodialysis and Non-pharmacological Management.

Gerogianni G Cureus. 2023; 15(2):e35448.

PMID: 36994274 PMC: 10042210. DOI: 10.7759/cureus.35448.

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