Skip to main content

Research Repository

Advanced Search

Prescribing non-opioid drugs in end-stage kidney disease

Wilcock, Andrew; Charlesworth, Sarah; Twycross, Robert; Waddington, Anne; Worthington, Olivia; Murtagh, Fliss E.M.; Beavis, Jenny; King, Samuel; Mihalyo, Mary; Kotlinska-Lemieszek, Aleksandra

Authors

Andrew Wilcock

Sarah Charlesworth

Robert Twycross

Anne Waddington

Olivia Worthington

Jenny Beavis

Samuel King

Mary Mihalyo

Aleksandra Kotlinska-Lemieszek



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.

Citation

Wilcock, A., Charlesworth, S., Twycross, R., Waddington, A., Worthington, O., Murtagh, F. E., …Kotlinska-Lemieszek, A. (2017). Prescribing non-opioid drugs in end-stage kidney disease. Journal of pain and symptom management, 54(5), 776-787. https://doi.org/10.1016/j.jpainsymman.2017.08.014

Journal Article Type Article
Acceptance Date Aug 16, 2017
Online Publication Date Aug 24, 2017
Publication Date 2017-11
Deposit Date Nov 15, 2017
Publicly Available Date Mar 28, 2024
Journal Journal of pain and symptom management
Print ISSN 0885-3924
Electronic ISSN 1873-6513
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 54
Issue 5
Pages 776-787
DOI https://doi.org/10.1016/j.jpainsymman.2017.08.014
Keywords End-stage kidney disease; Kidney failure; Opioids
Public URL https://hull-repository.worktribe.com/output/456521
Publisher URL https://www.sciencedirect.com/science/article/pii/S0885392417304190
Additional Information This is the accepted manuscript of an article published in Journal of pain and symptom management, 2017. The version of record is available at the DOI link in this record.

Files





You might also like



Downloadable Citations