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Nephrol Dial Transplant. 2014 Sep;29 Suppl 4:iv142-53. doi: 10.1093/ndt/gfu073.

A stepwise approach for effective management of chronic pain in autosomal-dominant polycystic kidney disease.

Author information

1
Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
2
Department of Gastroenterology and Hepatology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands.
3
Pain Centre, Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
4
Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.

Abstract

Chronic pain, defined as pain existing for >4-6 weeks, affects >60% of patients with autosomal-dominant polycystic disease (ADPKD). It can have various causes, indirectly or directly related to the increase in kidney and liver volume in these patients. Chronic pain in ADPKD patients is often severe, impacting physical activity and social relationships, and frequently difficult to manage. This review provides an overview of pathophysiological mechanisms that can lead to pain and discusses the sensory innervation of the kidneys and the upper abdominal organs, including the liver. In addition, the results of a systematic literature search of ADPKD-specific treatment options are presented. Based on pathophysiological knowledge and evidence derived from the literature an argumentative stepwise approach for effective management of chronic pain in ADPKD is proposed.

KEYWORDS:

ADPKD; management; pain; polycystic kidney disease; polycystic liver disease

PMID:
25165181
PMCID:
PMC4217572
DOI:
10.1093/ndt/gfu073
[Indexed for MEDLINE]
Free PMC Article

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