Health-Related Quality of Life in Patients With Autosomal Dominant Polycystic Kidney Disease and CKD Stages 1-4: A Cross-sectional Study

Miskulin, Dana C.; Abebe, Kaleab Z.; Chapman, Arlene B.; Perrone, Ronald D.; Steinman, Theodore I.; Torres, Vicente E.; Bae, Kyongtae T.; Braun, William E.; Winklhofer, Franz T.; Hogan, Marie C.; Rahbari-Oskoui, Frederic F.; Moore, Charity G.; Flessner, Michael F.; Schrier, Robert W.

doi:10.1053/j.ajkd.2013.08.017

Cited by 100 publications

(133 citation statements)

References 24 publications

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“…4,5 Deterioration of renal function is usually proportional to the increase in kidney size, and many patients with ADPKD and renal dysfunction have massive kidneys. They develop various symptoms related to abdominal distension that impair their quality of life, 6,7 and there can also be an adverse influence on the prognosis. Methods for reducing the size of enlarged kidneys include aspiration and injection of sclerosant into renal cysts, 8,9 surgical and laparoscopic cyst fenestration, 8,[10][11][12] and surgical and laparoscopic nephrectomy.…”

mentioning

confidence: 99%

Suitability of Patients with Autosomal Dominant Polycystic Kidney Disease for Renal Transcatheter Arterial Embolization

Suwabe

Ubara

Mise

et al. 2015

JASN

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In patients with autosomal dominant polycystic kidney disease (ADPKD), massive renal enlargement is a serious problem. Renal transcatheter arterial embolization (TAE) can reduce renal volume (RV), but effectiveness varies widely, and the reasons remain unclear. We investigated factors affecting renal volume reduction rate (RVRR) after renal TAE in all 449 patients with ADPKD who received renal TAE at Toranomon Hospital from January of 2006 to July of 2013, including 228 men and 221 women (mean age =57.069.1 years old). One year after renal TAE, the RVRR ranged from 3.9% to 84.8%, and the least squares mean RVRR calculated using a linear mixed model was 45.5% (95% confidence interval [95% CI], 44.2% to 46.8%). Multivariate analysis using the linear mixed model revealed that RVRR was affected by the presence of large cysts with wall thickening (regression coefficient [RC], 26.10; 95% CI, 29.04 to 23.16; P,0.001), age (RC, 20.82; 95% CI, 21.03 to 20.60; P,0.001), dialysis duration (RC, 20.10; 95% CI, 20.18 to 20.03; P,0.01), systolic BP (RC, 0.39; 95% CI, 0.19 to 0.59; P,0.001), and the number of microcoils used for renal TAE (RC, 1.35; 95% CI, 0.83 to 1.86; P,0.001). Significantly more microcoils were needed to achieve renal TAE in patients with younger age and shorter dialysis duration. In conclusion, cyst wall thickening had an important effect on cyst volume reduction. Renal TAE was more effective in patients who were younger, had shorter dialysis duration, or had hypertension, parameters that might associate with cyst wall stiffness and renal artery blood flow.

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mentioning

confidence: 99%

Suitability of Patients with Autosomal Dominant Polycystic Kidney Disease for Renal Transcatheter Arterial Embolization

Suwabe

Ubara

Mise

et al. 2015

JASN

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“…Comparing pain intensity in women and men did not show a significant difference and the results were the same with FPS-R and NRS scales. However, other studies indicated that the pain intensity in women was higher than men (23,24). In a study done in California, older women, with a low income, who were insufficiently active during their leisure time, had higher prevalence of chronic pain (25).…”

Section: Discussionmentioning

confidence: 92%

Comparing Two Scales: FPS-R and NRS for Pain Measurement in Elderly Bedridden Population of Hamadan-Iran

et al. 2017

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Background: Pain is a common complaint of the elderly and it is important to evaluate pain intensity carefully in aged people. There are different self-report scales for pain evaluation in elderly individuals, however, only a few studies have compared these scales. This study was conducted to compare 2 regular pain scales: FPS-R and NRS in the elderly population. Methods: In this cross sectional study, we evaluated 2 different pain assessment tools. A total of 120 bedridden patients, who were older than 65 years, and were admitted in governmental hospitals in Hamadan-Iran were studied during 3 months (May-July 2016). For evaluating pain, we used the FPS-R (faces pain scale-revised) and NRS (numerical rating scale). All participants' information were gathered in a checklist and analyzed using the SPSS 16 software. Results: All patients had some degree of pain that started from 1 month to over 6 months ago, among them, 115 (96%) had persistent pain. The mean pain intensity in the participants was similar with both scales. There was a strong correlation between the 2 scales when using the Pearson correlation method (r = 0.735, P < 0.001). The age group analysis showed a significant difference in different age subgroups, therefore, the 75 -85 year old age group had the highest and > 85 years old had the lowest pain intensity (7.07 vs. 5.36, respectively using NRS, PV = 0.014) Conclusions: Pain has a remarkable prevalence in bedridden patients in Hamadan. Both scales: the FPS-R and NRS scales had a strong correlation for measuring pain intensity in the elderly patient population, however, simplicity of the FPS-R scale for use with the older adults, makes it an appropriate pain scale in clinical practice. Future studies need to evaluate a suitable management pain for older adults.

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“…8 Pain is not related to kidney size early in the disease process (eGFR>60mL/min/1.73m 2 ) unless the kidneys are extremely large with a height adjusted kidney volume greater than 1,000 mL/m. 5 Pain presentation based on cyst size can be variable as some patients with smaller cysts can experience severe pain, while other patients with larger cysts remain pain free. 6 Renal associated pain in ADPKD can present in various ways, making it difficult to clinically confirm its etiology.…”

Section: Chronic Renal Painmentioning

confidence: 99%

“…5 Compression on the stomach and duodenum can result in decreased appetite and abdominal fullness, leading to a risk of malnutrition. 5,6 Chronic Liver Pain in ADPKD Hepatic cysts in ADPKD can be identified in up to 94% of patients ages 35-46 years through magnetic resonance imaging. The cyst volume and incidence increases with age as the disease progresses.…”

Section: Abdominal Fullness and Early Satietymentioning

confidence: 99%

“…4 The difficulty of pain management is demonstrated by many patients, with up to 39% of patients being somewhat or completely dissatisfied with pain treatment because they are physically unable to do what they would like. 5 A better understanding of the etiology of pain that occurs in ADPKD in addition to the underlying anatomy can help to guide treatment.…”

Section: Introductionmentioning

confidence: 99%

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Management of Pain in Autosomal Dominant Polycystic Kidney Disease and Anatomy of Renal Innervation

et al. 2015

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Purpose: Chronic pain is a prominent feature of autosomal dominant polycystic kidney disease (ADPKD) that is difficult to treat and manage, often resulting in a decrease in quality of life. Understanding the underlying anatomy of renal innervation and different etiologies of pain that occur in ADPKD can help to guide proper treatments to manage pain. Reviewing the previously studied treatments for pain in ADPKD can help to characterize treatment in a stepwise fashion. Materials and Methods: We performed a literature search of the etiology and management of pain in ADPKD and the anatomy of renal innervation using Pubmed® and Embase® from January 1985 to April 2014 with limitations to human studies and English language. Results: Pain occurs in the majority of patients with ADPKD due to renal, hepatic, and mechanical origins. Patients may experience different types of pain, which can make it difficult to clinically confirm its etiology. An anatomical and histological evaluation of the complex renal innervation helps with an understanding of the mechanisms that can lead to renal pain. Understanding the complex nature of renal innervation is essential for surgeons to perform a renal denervation procedure. The management of pain in ADPKD should be approached in a stepwise fashion. Acute causes of renal pain must first be ruled out due to the high incidence in ADPKD. For chronic pain, non-opioid analgesics and conservative interventions can be first used before opioid analgesics are considered. If pain continues, there are surgical interventions that can target pain produced by renal or hepatic cysts. Surgical options include renal cyst decortication, renal denervation, and nephrectomy. Conclusion: Chronic pain in patients with ADPKD is often refractory to conservative, medical, and other non-invasive treatments. There are effective surgical procedures that can be implemented when more conservative treatments fail. Laparoscopic cyst decortication has been well studied and results in relief of chronic renal pain in the majority of patients. In addition, renal denervation has successfully been utilized and could be performed concurrently with cyst decortication. Nephrectomy should be reserved for patients with intractable pain and renal failure when other modalities have failed.

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Health-Related Quality of Life in Patients With Autosomal Dominant Polycystic Kidney Disease and CKD Stages 1-4: A Cross-sectional Study

Cited by 100 publications

References 24 publications

Suitability of Patients with Autosomal Dominant Polycystic Kidney Disease for Renal Transcatheter Arterial Embolization

Suitability of Patients with Autosomal Dominant Polycystic Kidney Disease for Renal Transcatheter Arterial Embolization

Comparing Two Scales: FPS-R and NRS for Pain Measurement in Elderly Bedridden Population of Hamadan-Iran

Management of Pain in Autosomal Dominant Polycystic Kidney Disease and Anatomy of Renal Innervation

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