[Evaluation and analysis of pain in chronic hemodialysis]

Abstract

Aim: Pain is an unpleasant experience that deeply affects patients' quality of life and emotional state. Pain's epidemiology and characteristics in chronic hemodialysis are not well known and insufficiently analysed. The aim of our study was to assess the prevalence, characteristics, impact and treatment of pain in our hemodialysis patients and determine its related associated factors.

Methods: We performed a cross-sectional study including 93 chronic hemodialysis patients. We collected demographic data as well as the aspects of the reported pain on the basis of the concise pain questionnaire, and finally inferred the risk factors related to pain occurrence. Chronic pain was defined as a pain that has existed for over three months.

Results: The prevalence of pain was 70.9% (n=66), mean age 55.3±13.3 years, sex ratio 30 males/36 females, mean duration of hemodialysis 82.4±57.29 (6-252) months. This pain was permanent, daily, intermittent and rare in respectively 9%, 28.7%, 48.4% and 13.6% of cases. It was mild, moderate, severe or unbearable in respectively 42.8%, 23.8%, 19% and 14.2% of cases. Pain was multifocal in 57.4% of cases. The most frequently reported pain sites were: shoulders (47.2%), head (41.2%), knee (34.5%) and back (20%). Thus, 53.8% of patients reported using analgesics, with a daily intake, frequent or rare in respectively 28%, 44% and 28% of cases. The comparison between the group of patients reporting pain to the one without pain complaints in univariate statistical analysis found that age, Charlson's score, interdialytic weight gain and the rate of two dialysis sessions per week were linked to pain occurrence. However, in multivariate analysis, only age remained as a pain-associated factor.

Conclusion: Pain in chronic hemodialysis patients is a very common complaint. Therefore, it is necessary to assess it regularly, using a suitable questionnaire.

Keywords: Chronic hemodialysis; Comorbidities; Comorbidités; Douleur; Emotional state; Hémodialyse chronique; Pain; État psychoaffectif.