#634 The role of pain in reducing quality of life in patients with stage 5 CKD: a systematic review

Abstract Background and Aims Pain is a common but often undertreated symptom in patients with chronic kidney disease (CKD), with a much higher prevalence than in the general population. In the general population, the prevalence of pain in patients with chronic kidney disease (CKD) is reported to be 40 to 60% for patients receiving renal replacement therapy (RRT), 60 to 70% for patients with pre-terminal kidney disease (PTKD), and up to 100% for hospitalized patients with CKD. Musculoskeletal pain predominates at 60%–70% in both the general and CKD populations [1]. The aim of this systematic review is to obtain up-to-date population-based estimates of the prevalence of different types of pain in different subgroups of the CKD patient population (CKD without dialysis, dialysis, kidney transplant recipients, palliative care), and the impact of chronic pain on the quality of life of patients with end-stage renal disease (ESRD). Method a retro and prospective analysis of 1767 medical records of patients aged 20 to 75 years hospitalized in various departments of the State Institution "Republican Specialized Scientific and Practical Medical Center for Nephrology and Kidney Transplantation" for 2021–2023 was carried out. The study to assess QOL was carried out using the Russian-language version of the SF36 questionnaire (short form medical outcomes study), which is most often used abroad (USA, European countries) and in domestic studies on clinical medicine, and allows for a quantitative description of the physical, psychological and social components of QOL. Statistical processing was performed in Microsoft Office Excel 2023. Results the main causes of chronic kidney disease are: diabetic nephropathy—23.76% (420), hypertensive nephrosclerosis—18.9% (334), chronic glomerulonephritis—32.48% (574), tubulointerstitial nephritis—7.38% (13), cystic kidney disease—18.05 (319) and others—5.94% (105). In the survey results, such a factor as the use of tobacco products: 51.49% (910) have never used, 16.41% (290) currently smoke, 31.91% (564) of patients previously smoked. The severity of pain syndrome according to the pain intensity scale in patients with CKD stage 5 was: average values 83.42 ± 21.12 points, in men 86.58 ± 19.15 and 78.48 ± 22.7, in women, there was a statistically significant difference in the intensity of pain syndrome between males and females (P < 0.001). There was no statistically significant correlation between the VAS indicators and the etiology of CKD (Pearson coefficient—0.06). This confirms the postulate that the etiology of CKD is not related to the severity of pain. The pain intensity scale (bodily pain—BP) indicates the impact of pain on the ability to perform daily activities, including work at home and outside the home. Low scores indicate that pain significantly limits the patient's activity, for example: 0–10 points—unbearable pain (absolute disorders); 10–30 points—severe pain (severe disorders); 40–60 points—moderate pain (moderate disorders); 60–80 points—moderate pain (moderate disorders); 80–90 points—mild pain (mild disorders); 100 points—no disorders. According to the questionnaire results, unbearable pain was noted in 10 patients, severe pain in 72 patients, moderate pain in 1447 patients, mild pain in 238 patients and 79 patients did not experience pain syndrome. Conclusions The results of the assessment of the quality of life of patients with terminal CKD, corrected by PG, allow us to identify the features of the holistic, both physical and mental, response of the patient's body to the pathological process and tolerability of treatment, which must be taken into account when prescribing planned and emergency treatment measures. Pain has a significant negative impact on quality of life in patients with CRF undergoing PG. Subgroups with higher risk included older patients, women, patients with higher BMI, individuals without higher education, unemployed, individuals with low monthly income, smokers, individuals with multiple comorbidities, and patients with longer dialysis experience.

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