International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Vol. 8, Issue 2, pp: (230-239), Month: October 2020 - March 2021, Available at: www.researchpublish.com
SYSTEMATIC REVIEW: PHARMACOLOGICAL MANAGEMENT OF CHRONIC KIDNEY DISEASE PATIENTS WITH NEUROPATHIC PAIN UNDER HAEMODIALYSIS Pratheeprao Sathianantharao1, Ida Ayu Sri Wijayanti 2, Anna Marita Gelgel2, I Made Oka Adnyana2 1
Medicine and Doctor Profession, Medical Faculty of Udayana University, Denpasar, Bali
2
Departement of Neurology, RSUP Sanglah, Faculty of Medicine Udayana University, Denpasar, Bali Email: pratheepr14@gmail.com
Abstract: Neuropathic pain is pain arising from a disease or lesion that affects the somatosensory system. In Indonesia, neuropathic pain is found in 31.6% with almost 75% of cases experiencing chronic pain and disrupting the patient's daily activities and quality of life. Neuropathic pain is an important comorbid factor in impaired renal function or chronic renal failure with hemodialysis. Objective to determine the pharmacological management of overall opioids use and the use of different types of opioids including acetaminophen, antiinflammatory drugs (NSAIDs), adjuvants, and opioids in patients with chronic kidney disease under hemodialysis.Systematic review with inclusion and exclusion criteria through search engines obtained 114 journals that were reviewed. 8 journals were used as main references in writing this review. The data obtained are in the form of qualitative and quantitative data which are then arranged systematically and according to each topic discussed so that a conclusion is obtained that represents the entire content of the review. We observed that opioids such as morphine and codeine were associated with a significantly higher risk of altered mental status in patients receiving hemodialysis. There is no evidence that at equivalent analgesic efficacy weak opioids carry a lower risk of addiction than low-dose strong opioids. Safe opioid that are recommended such as transdermal fentanyl patch, methadone, buprenorphine are opioid groups which are said to be relatively safe. Gabapentin and pregabalin are the two most common anticonvulsants used and SNRIs are renally cleared except for duloxetine. Pharmacological management of neuropathic pain in chronic kidney disease with hemodialysis that can vary between type of opioids consumed and the effectiveness of the opioids used. Keywords: neuropathic pain, chronic kidney disease, hemodialysis.
1. INTRODUCTION Pain is an unpleasant sensory and emotional experience due to tissue damage, both actual and potential. Pain is the most common reason why patients come to seek medical help. The feeling of pain is a warning that there is tissue damage it can provide a warning to avoid danger that can be life threatening. Based on the mechanism, pain divided into nociceptive pain, neuropathic pain, and mixed pain.1 Neuropathic pain is pain arising from a disease or lesion affecting the somatosensory system. In simple terms, this type of pain occurs when nerves in the central nervous system are injured or damaged. Neuropathic pain may coexist with other types of pain such as nociceptive pain or pain due to damage to non-
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