Pain-related Factors in Hemodialysis Patients

Pain in Hemodialysis Patients

Abstract

Background: Pain is a prevalent issue among patients undergoing hemodialysis (HD). This study aimed to evaluate the prevalence of pain and identify factors associated with pain in HD patients.

Methods: Two hundred two HD patients participated in the study. Demographic and clinical data, pain characteristics, and sleep quality were recorded. Symptom burden and pain severity were assessed using the Edmonton Symptom Assessment Scale (ESAS) and the McGill-Melzack Pain (MGP) questionnaire.

Results: The majority of participants were male (59.9%), with a mean age of 59.6±12.7 years. Pain was reported by 80.2% of the patients and was significantly more prevalent among females (p=0.001) and individuals with lower educational levels (p=0.005). Median ESAS and MGP scores were 20 (range: 4-84) and 47 (range: 22-84), respectively. Patients reporting pain had significantly higher levels of CRP (p=0.044), parathyroid hormone (p=0.005), and higher ESAS scores (p=0.001). Sleep quality was impaired in 37% of patients. ESAS scores were significantly higher among females (p=0.003), those with impaired sleep quality (p<0.001), and regular analgesic users (p=0.002). MGP scores were significantly elevated in patients with diabetes (p=0.002), lower educational attainment (p=0.022), daily pain occurrence (p<0.001), and poor sleep quality (p<0.001). Additionally, patients with pain in multiple body regions reported higher MGP scores (p<0.001). There was a significant correlation between MGP scores, age (p=0.001), and ESAS scores (p<0.001).

Conclusion: Pain is highly prevalent among HD patients and is associated with female gender, lower educational level, elevated CRP, and higher parathyroid hormone levels. The severity of pain is particularly influenced by diabetes, low education level, and the number of painful body regions. Moreover, pain significantly impacts symptom burden and sleep quality.