Журнал нефрологии и терапии

Chronic Pain in Hemodialysis Patients in Three Reference Centres in Senegal: Prevalence, Psycho-affective Impact and Associated Factors

Abstract

M Faye1, A Dieng*2, MA Ba1, JH Sambou2, MS Diawara2, MO Faye1, AT Lemrabott1, El Fary KA1 and MM Cissé2

Introduction: The prevalence of chronic pain is high on hemodialysis patients. It can alter the quality of life of these patients who are already exposed to numerous comorbidities. This study aimed to determine the characteristics, the psycho-affective impact and the chronic pain-related factors.

Patients and Methods: We conducted a cross-sectional, multicentre study of descriptive and analytical purposes in 3 centres in Senegal including 110 chronic haemodialysis patients. Sociodemographic, biological and therapeutic patterns were studied. The pain was considered chronic when it lasted more than 3 months. The intensity of the pain was explored according to the degree of understanding of the patients by different assessment scales.

Results: The mean age of our patients was 48.15 ± 13.71 years and a sex ratio (M/F) of 1.07. The main causative nephropathy was nephroangiosclerosis in 43.6% and the mean duration of haemodialysis was 76 ± 46.4 months. The prevalence of chronic pain was 39.09% (43/110). It was experienced as mild (11.6%), moderate (30.2%), severe (41.9%) and unbearable (16.3%) according to the visual analogue scale (VAS). It was permanent, intermittent, daily and rare in 27.91%, 25.58%, 27.91% and 18.60% respectively. The site of the pain was multiple in 60.47% with a predominance of osteoarticular pain in 81.39%. The psycho-affective impact was certain in 51%. Analgesic use was noted in 55.81%, with the use of level 1 (79.2%) and level 2 (25%). The response of analgesics to chronic pain was unchanged (4.16%), reduced (54.16%) and amended (41.66%). Analgesic dependence was noted in 20.83%. In univariate analysis, only calcium levels were statistically significantly related to chronic pain. In multivariate analysis, the factors associated with pain were age, length of time on haemodialysis and blood calcium.

Conclusion: The prevalence of chronic pain is relatively high. It requires a special attention by all chronic haemodialysis staff. Hence, the use of valid assessment tools in dialysis patients would allow a better estimation of the prevalence.