Therapeutic Cannabis Use in Kidney Disease: A Survey of Canadian NephrologistsPlain-Language Summary

Rationale & Objective: Cannabis use may be helpful for symptom management in patients with chronic kidney disease (CKD). Knowledge, attitudes, and comfort with use of medical cannabis among kidney care providers may be limiting more widespread evaluation and use. We surveyed Canadian nephrologists regarding current prescribing habits, attitudes, and overall comfort level with cannabis products. Study Design: We carried out a nationwide, mail-in survey focused on capturing general and practice demographics, current cannabis prescribing status, and knowledge and attitudes regarding therapeutic cannabis use in patients with CKD. Setting & Population: This survey was distributed to every registered nephrologist in Canada. Analytical Approach: The results of this survey are reported descriptively. Results: Responses were received from 208 of 723 (29%) nephrologists. Only 21 (10.1%) respondents currently prescribe cannabis, with chronic pain syndromes being the most frequent reason for cannabis prescription (95.2%). Overall, 116 (55.5%) participants reported that changes in legality of cannabis did not influence their decision to prescribe cannabis. The majority of respondents (n = 123; 59%) indicated that they were uncomfortable with their knowledge of the medical cannabis literature. Most respondents (n=188; 91%) indicated that further studies exploring the efficacy and safety of cannabis would likely influence their prescribing habits. Limitations: Limitations of this study include possible nonresponse bias and a lack of specific data on practice considerations for specific subpopulations, such as transplant patients. Conclusions: Only a small minority of Canadian nephrologists currently prescribe cannabis, with relatively little practice change after legalization. There is broad support amongst Canadian nephrologists for encouraging their patients to enroll in efficacy/safety studies of cannabis in the CKD population. Ultimately, given limited therapeutic options available for symptom control in CKD, this survey demonstrates the potential for nationwide practice change if cannabis efficacy and safety can be demonstrated in this population.