Multidisciplinary management of chronic refractory pain in autosomal dominant polycystic kidney disease
ABSTRACT Background Chronic pain is often difficult to manage in autosomal dominant polycystic kidney disease (ADPKD) patients and sometimes even leads to nephrectomy. We analyzed the long-term efficacy of our innovative multidisciplinary protocol to treat chronic refractory pain that aims to preser...
Gespeichert in:
| Veröffentlicht in: | Nephrology, dialysis, transplantation dialysis, transplantation, 2023-02, Vol.38 (3), p.618-629 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 629 |
|---|---|
| container_issue | 3 |
| container_start_page | 618 |
| container_title | Nephrology, dialysis, transplantation |
| container_volume | 38 |
| creator | van Luijk, Franka Gansevoort, Ron T Blokzijl, Hans Groen, Gerbrand J de Haas, Robbert J Leliveld, Anna M Meijer, Esther Perdok, Joke M Stellema, Ruud Wolff, Andreas P Casteleijn, Niek F |
| description | ABSTRACT
Background
Chronic pain is often difficult to manage in autosomal dominant polycystic kidney disease (ADPKD) patients and sometimes even leads to nephrectomy. We analyzed the long-term efficacy of our innovative multidisciplinary protocol to treat chronic refractory pain that aims to preserve kidney function by applying among other sequential nerve blocks.
Methods
Patients were eligible if pain was present ≥3 months with a score of ≥50 on a visual analog scale (VAS) of 100, was negatively affecting quality of life and if there had been insufficient response to previous therapies, including opioid treatment. Treatment options were, in order, analgesics, cyst aspiration and fenestration, nerve blocks and nephrectomy.
Results
A total of 101 patients were assessed in our clinic (mean age 50 ± 11 years, 65.3% females). Eight patients were treated with medication, 6 by cyst aspiration or fenestration, 63 by nerve blocks and 6 received surgery as the first treatment option. Overall, 76.9% experienced a positive effect on pain complaints shortly after treatment. The VAS score was reduced from 60/100 to 20/100 (P |
| doi_str_mv | 10.1093/ndt/gfac158 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9976741</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/ndt/gfac158</oup_id><sourcerecordid>2661090429</sourcerecordid><originalsourceid>FETCH-LOGICAL-c412t-cfd064247cf6885d987c1a4a5daeb6c8f8cb913100ae2c703fc852dfd32f07093</originalsourceid><addsrcrecordid>eNp9UU1rGzEUFCEldtKeei97CoGwsaRdrXYvgWD6EXDIpT2LZ33YSnal7Wo34H_fZ-ya5lIQ6PBm5r2ZIeQzo3eMNsUimHGxcaCZqM_InJUVzXlRi3MyxynLqaDNjFym9EIpbbiUF2RWCMG4kMWcbJ6mdvTGJ-371gcYdlkHATa2s2HMosv0dojB62ywbgA9RgT04EOGD6YxpthBm5nYIRcJfWx3epdGJLx6E-wuQ2kLyX4kHxy0yX46_lfk17evP5c_8tXz98flwyrXJeNjrp2hVclLqV1V18I0tdQMShAG7LrStav1umEFoxQs15IWTteCG2cK7qhEv1fk_qDbT-vOGo0uBmhVP_gOvakIXr2fBL9Vm_immkZWsmQocHMUGOLvyaZRdRiObVsINk5J8arC1GnJ97tuD1A9xJQwoNMaRtW-GoXVqGM1iP7y72Un7N8uEHB9AMSp_6_SH4yynHU</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2661090429</pqid></control><display><type>article</type><title>Multidisciplinary management of chronic refractory pain in autosomal dominant polycystic kidney disease</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>van Luijk, Franka ; Gansevoort, Ron T ; Blokzijl, Hans ; Groen, Gerbrand J ; de Haas, Robbert J ; Leliveld, Anna M ; Meijer, Esther ; Perdok, Joke M ; Stellema, Ruud ; Wolff, Andreas P ; Casteleijn, Niek F</creator><creatorcontrib>van Luijk, Franka ; Gansevoort, Ron T ; Blokzijl, Hans ; Groen, Gerbrand J ; de Haas, Robbert J ; Leliveld, Anna M ; Meijer, Esther ; Perdok, Joke M ; Stellema, Ruud ; Wolff, Andreas P ; Casteleijn, Niek F</creatorcontrib><description>ABSTRACT
Background
Chronic pain is often difficult to manage in autosomal dominant polycystic kidney disease (ADPKD) patients and sometimes even leads to nephrectomy. We analyzed the long-term efficacy of our innovative multidisciplinary protocol to treat chronic refractory pain that aims to preserve kidney function by applying among other sequential nerve blocks.
Methods
Patients were eligible if pain was present ≥3 months with a score of ≥50 on a visual analog scale (VAS) of 100, was negatively affecting quality of life and if there had been insufficient response to previous therapies, including opioid treatment. Treatment options were, in order, analgesics, cyst aspiration and fenestration, nerve blocks and nephrectomy.
Results
A total of 101 patients were assessed in our clinic (mean age 50 ± 11 years, 65.3% females). Eight patients were treated with medication, 6 by cyst aspiration or fenestration, 63 by nerve blocks and 6 received surgery as the first treatment option. Overall, 76.9% experienced a positive effect on pain complaints shortly after treatment. The VAS score was reduced from 60/100 to 20/100 (P < 0.001) and patients decreased their number of nonopioid and opioid analgesics significantly (P < 0.001, P = 0.01, respectively). A substantial number of the patients (n = 51) needed additional treatment. At the end of follow-up in only 13 patients (12.9%) was surgical intervention necessary: 11 nephrectomies (of which 10 were in patients already on kidney function replacement treatment), 1 liver transplantation and 1 partial hepatectomy. After a median follow-up of 4.5 years (interquartile range 2.5–5.3), 69.0% of the patients still had fewer pain complaints.
Conclusions
These data indicate that our multidisciplinary treatment protocol appears effective in reducing pain in the majority of patients with chronic refractory pain, while postponing or even avoiding in most patients surgical interventions such as nephrectomy in most patients.
Graphical Abstract
Graphical Abstract</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfac158</identifier><identifier>PMID: 35512573</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Chronic Pain - therapy ; Cysts ; Female ; Humans ; Male ; Middle Aged ; Nephrectomy ; Original ; Pain, Intractable - surgery ; Polycystic Kidney, Autosomal Dominant ; Quality of Life</subject><ispartof>Nephrology, dialysis, transplantation, 2023-02, Vol.38 (3), p.618-629</ispartof><rights>The Author(s) 2022. Published by Oxford University Press on behalf of the ERA. 2022</rights><rights>The Author(s) 2022. Published by Oxford University Press on behalf of the ERA.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c412t-cfd064247cf6885d987c1a4a5daeb6c8f8cb913100ae2c703fc852dfd32f07093</citedby><cites>FETCH-LOGICAL-c412t-cfd064247cf6885d987c1a4a5daeb6c8f8cb913100ae2c703fc852dfd32f07093</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35512573$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Luijk, Franka</creatorcontrib><creatorcontrib>Gansevoort, Ron T</creatorcontrib><creatorcontrib>Blokzijl, Hans</creatorcontrib><creatorcontrib>Groen, Gerbrand J</creatorcontrib><creatorcontrib>de Haas, Robbert J</creatorcontrib><creatorcontrib>Leliveld, Anna M</creatorcontrib><creatorcontrib>Meijer, Esther</creatorcontrib><creatorcontrib>Perdok, Joke M</creatorcontrib><creatorcontrib>Stellema, Ruud</creatorcontrib><creatorcontrib>Wolff, Andreas P</creatorcontrib><creatorcontrib>Casteleijn, Niek F</creatorcontrib><title>Multidisciplinary management of chronic refractory pain in autosomal dominant polycystic kidney disease</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol Dial Transplant</addtitle><description>ABSTRACT
Background
Chronic pain is often difficult to manage in autosomal dominant polycystic kidney disease (ADPKD) patients and sometimes even leads to nephrectomy. We analyzed the long-term efficacy of our innovative multidisciplinary protocol to treat chronic refractory pain that aims to preserve kidney function by applying among other sequential nerve blocks.
Methods
Patients were eligible if pain was present ≥3 months with a score of ≥50 on a visual analog scale (VAS) of 100, was negatively affecting quality of life and if there had been insufficient response to previous therapies, including opioid treatment. Treatment options were, in order, analgesics, cyst aspiration and fenestration, nerve blocks and nephrectomy.
Results
A total of 101 patients were assessed in our clinic (mean age 50 ± 11 years, 65.3% females). Eight patients were treated with medication, 6 by cyst aspiration or fenestration, 63 by nerve blocks and 6 received surgery as the first treatment option. Overall, 76.9% experienced a positive effect on pain complaints shortly after treatment. The VAS score was reduced from 60/100 to 20/100 (P < 0.001) and patients decreased their number of nonopioid and opioid analgesics significantly (P < 0.001, P = 0.01, respectively). A substantial number of the patients (n = 51) needed additional treatment. At the end of follow-up in only 13 patients (12.9%) was surgical intervention necessary: 11 nephrectomies (of which 10 were in patients already on kidney function replacement treatment), 1 liver transplantation and 1 partial hepatectomy. After a median follow-up of 4.5 years (interquartile range 2.5–5.3), 69.0% of the patients still had fewer pain complaints.
Conclusions
These data indicate that our multidisciplinary treatment protocol appears effective in reducing pain in the majority of patients with chronic refractory pain, while postponing or even avoiding in most patients surgical interventions such as nephrectomy in most patients.
Graphical Abstract
Graphical Abstract</description><subject>Adult</subject><subject>Chronic Pain - therapy</subject><subject>Cysts</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nephrectomy</subject><subject>Original</subject><subject>Pain, Intractable - surgery</subject><subject>Polycystic Kidney, Autosomal Dominant</subject><subject>Quality of Life</subject><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><sourceid>EIF</sourceid><recordid>eNp9UU1rGzEUFCEldtKeei97CoGwsaRdrXYvgWD6EXDIpT2LZ33YSnal7Wo34H_fZ-ya5lIQ6PBm5r2ZIeQzo3eMNsUimHGxcaCZqM_InJUVzXlRi3MyxynLqaDNjFym9EIpbbiUF2RWCMG4kMWcbJ6mdvTGJ-371gcYdlkHATa2s2HMosv0dojB62ywbgA9RgT04EOGD6YxpthBm5nYIRcJfWx3epdGJLx6E-wuQ2kLyX4kHxy0yX46_lfk17evP5c_8tXz98flwyrXJeNjrp2hVclLqV1V18I0tdQMShAG7LrStav1umEFoxQs15IWTteCG2cK7qhEv1fk_qDbT-vOGo0uBmhVP_gOvakIXr2fBL9Vm_immkZWsmQocHMUGOLvyaZRdRiObVsINk5J8arC1GnJ97tuD1A9xJQwoNMaRtW-GoXVqGM1iP7y72Un7N8uEHB9AMSp_6_SH4yynHU</recordid><startdate>20230228</startdate><enddate>20230228</enddate><creator>van Luijk, Franka</creator><creator>Gansevoort, Ron T</creator><creator>Blokzijl, Hans</creator><creator>Groen, Gerbrand J</creator><creator>de Haas, Robbert J</creator><creator>Leliveld, Anna M</creator><creator>Meijer, Esther</creator><creator>Perdok, Joke M</creator><creator>Stellema, Ruud</creator><creator>Wolff, Andreas P</creator><creator>Casteleijn, Niek F</creator><general>Oxford University Press</general><scope>TOX</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20230228</creationdate><title>Multidisciplinary management of chronic refractory pain in autosomal dominant polycystic kidney disease</title><author>van Luijk, Franka ; Gansevoort, Ron T ; Blokzijl, Hans ; Groen, Gerbrand J ; de Haas, Robbert J ; Leliveld, Anna M ; Meijer, Esther ; Perdok, Joke M ; Stellema, Ruud ; Wolff, Andreas P ; Casteleijn, Niek F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c412t-cfd064247cf6885d987c1a4a5daeb6c8f8cb913100ae2c703fc852dfd32f07093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adult</topic><topic>Chronic Pain - therapy</topic><topic>Cysts</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nephrectomy</topic><topic>Original</topic><topic>Pain, Intractable - surgery</topic><topic>Polycystic Kidney, Autosomal Dominant</topic><topic>Quality of Life</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van Luijk, Franka</creatorcontrib><creatorcontrib>Gansevoort, Ron T</creatorcontrib><creatorcontrib>Blokzijl, Hans</creatorcontrib><creatorcontrib>Groen, Gerbrand J</creatorcontrib><creatorcontrib>de Haas, Robbert J</creatorcontrib><creatorcontrib>Leliveld, Anna M</creatorcontrib><creatorcontrib>Meijer, Esther</creatorcontrib><creatorcontrib>Perdok, Joke M</creatorcontrib><creatorcontrib>Stellema, Ruud</creatorcontrib><creatorcontrib>Wolff, Andreas P</creatorcontrib><creatorcontrib>Casteleijn, Niek F</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Luijk, Franka</au><au>Gansevoort, Ron T</au><au>Blokzijl, Hans</au><au>Groen, Gerbrand J</au><au>de Haas, Robbert J</au><au>Leliveld, Anna M</au><au>Meijer, Esther</au><au>Perdok, Joke M</au><au>Stellema, Ruud</au><au>Wolff, Andreas P</au><au>Casteleijn, Niek F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multidisciplinary management of chronic refractory pain in autosomal dominant polycystic kidney disease</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol Dial Transplant</addtitle><date>2023-02-28</date><risdate>2023</risdate><volume>38</volume><issue>3</issue><spage>618</spage><epage>629</epage><pages>618-629</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><abstract>ABSTRACT
Background
Chronic pain is often difficult to manage in autosomal dominant polycystic kidney disease (ADPKD) patients and sometimes even leads to nephrectomy. We analyzed the long-term efficacy of our innovative multidisciplinary protocol to treat chronic refractory pain that aims to preserve kidney function by applying among other sequential nerve blocks.
Methods
Patients were eligible if pain was present ≥3 months with a score of ≥50 on a visual analog scale (VAS) of 100, was negatively affecting quality of life and if there had been insufficient response to previous therapies, including opioid treatment. Treatment options were, in order, analgesics, cyst aspiration and fenestration, nerve blocks and nephrectomy.
Results
A total of 101 patients were assessed in our clinic (mean age 50 ± 11 years, 65.3% females). Eight patients were treated with medication, 6 by cyst aspiration or fenestration, 63 by nerve blocks and 6 received surgery as the first treatment option. Overall, 76.9% experienced a positive effect on pain complaints shortly after treatment. The VAS score was reduced from 60/100 to 20/100 (P < 0.001) and patients decreased their number of nonopioid and opioid analgesics significantly (P < 0.001, P = 0.01, respectively). A substantial number of the patients (n = 51) needed additional treatment. At the end of follow-up in only 13 patients (12.9%) was surgical intervention necessary: 11 nephrectomies (of which 10 were in patients already on kidney function replacement treatment), 1 liver transplantation and 1 partial hepatectomy. After a median follow-up of 4.5 years (interquartile range 2.5–5.3), 69.0% of the patients still had fewer pain complaints.
Conclusions
These data indicate that our multidisciplinary treatment protocol appears effective in reducing pain in the majority of patients with chronic refractory pain, while postponing or even avoiding in most patients surgical interventions such as nephrectomy in most patients.
Graphical Abstract
Graphical Abstract</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>35512573</pmid><doi>10.1093/ndt/gfac158</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0931-0509 |
| ispartof | Nephrology, dialysis, transplantation, 2023-02, Vol.38 (3), p.618-629 |
| issn | 0931-0509 1460-2385 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9976741 |
| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adult Chronic Pain - therapy Cysts Female Humans Male Middle Aged Nephrectomy Original Pain, Intractable - surgery Polycystic Kidney, Autosomal Dominant Quality of Life |
| title | Multidisciplinary management of chronic refractory pain in autosomal dominant polycystic kidney disease |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-10T08%3A59%3A48IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Multidisciplinary%20management%20of%20chronic%20refractory%20pain%20in%20autosomal%20dominant%20polycystic%20kidney%20disease&rft.jtitle=Nephrology,%20dialysis,%20transplantation&rft.au=van%20Luijk,%20Franka&rft.date=2023-02-28&rft.volume=38&rft.issue=3&rft.spage=618&rft.epage=629&rft.pages=618-629&rft.issn=0931-0509&rft.eissn=1460-2385&rft_id=info:doi/10.1093/ndt/gfac158&rft_dat=%3Cproquest_pubme%3E2661090429%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2661090429&rft_id=info:pmid/35512573&rft_oup_id=10.1093/ndt/gfac158&rfr_iscdi=true |