@article { , title = {Prescribing non-opioid drugs in end-stage kidney disease}, abstract = {Palliative care services are increasingly involved in the care of patients with chronic kidney disease, either alone or as a comorbid condition. Because renal impairment often changes the pharmacokinetic and/or pharmacodynamic effects of a drug, this presents a challenge for prescribers. This article provides guidance for prescribing non-opioid drugs commonly used for palliative care symptom relief in patients with end-stage kidney disease (ESKD; i.e. Chronic Kidney Disease Stage 5, eGFR <15mL/min/1.73m²) whether or not they are receiving dialysis. Opioids are not included, nor symptom relief in the last hours–days of life, because specific guidance is available elsewhere. Tables have been produced to highlight, when possible, the most, intermediate and least ‘renally safe’ drugs for chronic use. However, sometimes the cautious use of a familiar drug may be preferable to an unfamiliar (albeit ‘renally safer’) one. Similarly, we do not advocate the automatic switching of patients to a ‘renally safer’ drug when an alternative is proving satisfactory. Finally, this article aims to complement and not replace specialist renal unit guidance.}, doi = {10.1016/j.jpainsymman.2017.08.014}, eissn = {1873-6513}, issn = {0885-3924}, issue = {5}, journal = {Journal of pain and symptom management}, pages = {776-787}, publicationstatus = {Published}, publisher = {Elsevier}, url = {https://hull-repository.worktribe.com/output/456521}, volume = {54}, keyword = {Health and Health Inequalities, End-stage kidney disease, Kidney failure, Opioids}, year = {2017}, author = {Wilcock, Andrew and Charlesworth, Sarah and Twycross, Robert and Waddington, Anne and Worthington, Olivia and Murtagh, Fliss E.M. and Beavis, Jenny and King, Samuel and Mihalyo, Mary and Kotlinska-Lemieszek, Aleksandra} }