Buradasınız

AĞRILI HEMODİYALİZ HASTALARINDA GABAPENTİN TEDAVİSİ

GABAPENTIN IN THE TREATMENT OF PAIN IN HEMODIALYSIS PATIENTS

Journal Name:

Publication Year:

Keywords (Original Language):

Abstract (2. Language): 
Aim: Despite its high prevalence, pain induced by uremic neuropathy is usually underrecognized during diagnostic process and undertreated. In most of the patients, traditional drugs are ineffective. In this study, we investigated the effect of gabapentin on neuropathic pain along with quality of life (QOL) and depression in hemodialysis (HD) patients. Methods: Twenty two patients with chronic renal failure who were on HD were included in our study (10 males and 12 females, mean age 62±3.53). We administered 300 mg/day gabapentin for 8 weeks to patients in whom neuropathic pain was detected. We administered SF-36 Evaluation Test (Physical Component Score and Mental Component Score) for QOL, Beck s Depression Inventory (BDI) for depression and Short Form of McGill s Pain Questionnaire (SF-MPQ: VAS; Visual Analogue Score, PPI; Present Pain Intensity, total SF-MPQ) before and after the treatment. Results: With gabapentin treatment, we found a statistically significant decrease in pain scale scores. Total SF-MPQ decreased from 21.32±8.74 to 7.5±5.72, VAS scale decreased from 6.4±2.15 to 2.45±1.81, PPI decreased from 3.18±1.1 to 1.3±0.88. We also determined significant improvements in SF-36 and BDI scales (p<0.001). Conclusion: Gabapentin treatment improved pain which is a frequently encountered problem in HD patients and also made significant improvements in depression and quality of life.
Abstract (Original Language): 
Amaç: Üremik nöropatiye bağlı ağrı yüksek yaygınlığına rağmen, teşhis ve tedavi yönünden göz ardı edilmektedir. Bu hastalarda genellikle kullanılan ilaç tedavileri etkin değildir. Biz bu çalışmamızda, hemodiyaliz hastalarında gabapentinin nöropatik ağrıyla birlikte yaşam kalitesi ve depresyona etkisini araştırmayı amaçladık. Yöntem: Çalışmaya son dönem böbrek yetmezlikli 22 hemodiyaliz hastası dahil edildi (10 erkek ve 12 kadın, yaş ortalaması 62±3.53). Nöropatik ağrı tespit edilen hastalara 8 hafta süre ile günde 300 mg gabapentin tedavisi verildi. Tedaviden önce ve sonra yaşam kalitesi için SF-36 değerlendirme testi (fiziksel ve mental komponent skoru), depresyon için Beck depresyon envanteri (BDI) ve ağrı içinde Mc Gill ağrı anketi kısa formu (SFMPQ: VAS; Visual Analogue Score, PPI; Present Pain Intensity, total SF-MPQ) uygulandı. Bulgular:Gabapentin tedavisi ile birlikte ağrı skorlarında önemli derecede azalma tespit ettik. Total SF-MPQ skoru 21.32±8.74 den 7.5±5.72, VAS 6.4±2.15 den 2.45±1.81, PPI 3.18±1.1 den 1.3±0.88 düştü. Ayrıca SF-36 ve BDI skorlarında da anlamlı iyileşmeler tespit ettik (p<0.001). Hemodiyaliz hastalarında sık karşılaşılan bir sorun olan ağrıya gabapentin tedavisinin etkili olduğunu, bununla birlikte yaşam kalitesi ve depresyonda iyileşme sağladığını tespit ettik.
186-190

REFERENCES

References: 

1. Smith TE, Chong MS. Neuropathic pain.
Hosp Med. 61; 760-66, 2000.
2. Galer BS, Gianas A, Jensen ME Painful
diabetic polyneuropathy: Epidemiology,
paindescription, and quality of life.
Diabetes Res Clin Pract. 47; 123-8. 2000.
3. Clark MR, Heinberg L J, Haythornthwaite
JA, Quatrano-Piacentini AL, Pappagallo
M, Raja SN. Psychiatric symptoms and
distress differ between patients with
postherpetic neuralgia and peripheral
vestibular disease. J Psychomat Res 48;
51-7, 2000.
4. Benbow SJ, Wallymahmed ME, MacFarlane
IA. Diabetic peripheral neuropathy and
quality of life. QJ Med. 91; 733-7, 1998.
5. Haythornthwaite JA, Benrud-Larson LM.
Psychological assessment and treatment
of patients with neuropathic pain. Curt
Pain Headache Rep. 5; 124-9, 2001.
6. Rose MA, Kam PC. Gabapentin:
pharmacology and its use in pain
management. Anaesthesia 57; 451–62,
2002.
7. Yakut Y, Yakut E, Bayar K, Uygur F.
Reliability and validity of the Turkish
version short-form McGill pain
questionnaire in patients with rheumatoid
arthritis. Clin Rheumatol 26;1083-7,
2007.
8. Craven JL, Rodin GM, Littlefield C. The
Beck Depression Inventory as a screening
device for major depression in renal
dialysis patients. Int J Psychiatr Med 18;
365-74, 1988.
9. Kimmel PL, Peterson RA, Weihs KL,
Simmens SJ, Alleyne S, Cruz I, et al.
Multiple measurements of depression
predict mortality in a longitudinal study of
chronic hemodialysis outpatients. Kidney
Int 57; 2093-98, 2000.
10. Watnick S, Kirwin P, Mahnensmith R,
Concato J. The prevalence and treatment
of depression among patients starting
dialysis. Am J Kidney Dis 41; 105-10,
2003.
11. Koo JR, Yoon JW, Kim SG, Lee YK, Oh KH,
Kim GH, et al. Association of depression
with malnutrition in chronic hemodialysis
patients. Am J Kidney Dis 41; 1037–42,
2003.
12. Hisli N. Beck Depresyon Envanteri’nin
geçerliliği üzerine bir çalışma. Psikoloji
Dergisi 6; 118–22, 1998.
13. Ware JE Jr, Sherbourne CD. The MOS 36-
Item short-form health survey (SF-36) I:
conceptual frame work and item selection.
Med Care 30; 473-83, 1992.
14. Ware JE Jr. SF-36 Health Survey Manual
and Interpretation Guide. New England
Medical Center, Health Institute, Boston,
1993.
15. Ware JE Jr, Kosinski M, Bayliss MS,et al.
Comparison of methods for scoring and
statistical analysis of SF-36 health profile
and summary measures: summary of
results from the medical outcomes study.
Med Care 33: AS264-AS279, 1995.
16. Johansen KL, Painter P, Kent-Braun JA, Ng
AV, Carey S, Da Silva M, et al. Validation
of questionnaires to estimate physical
activity and functioning in end-stage renal
disease. Kidney Int 59; 1121-7, 2001.
17. Finkelstein FO, Finkelstein SH. Depression
in chronic dialysis patients: assessment
and treatment. Nephrol Dial Transplant
15; 1911-3, 2000.
18. Wuerth D, Finkelstein SH, Ciarcia J,
Peterson R, Kliger AS, Finkelstein FO.
Identification and treatment of depression
in a cohort of patients maintained on
chronic peritoneal dialysis. Am J Kidney
Dis 37; 1011-1017, 2001.
19. Kimmel PL. Psychosocial factors in dialysis
patients. Kidney Int 59; 1599-1613,
2001.
20. Kalender B, Ozdemir AC, Dervisoglu E,
Ozdemir O. Quality of life in chronic
kidney disease: effects of teratment
modality, depression, malnutrition and
inflammation. Int J Clin Pract 61 (4); 569-
76, 2007.
21. Young TL, Robb JC, Patelis-Siotis I,
MacDonald C, Joffe RT. Acute treatment of
bipolar depression with gabapentin. Biol
Psychiatry 42; 851–3, 1997.
22. Wang PW, Santosa C, Schumacher M,
Winsberg ME, Strong C, Katter TA.
Gabapentin augmentation therapy in
bipolar depression. Bipolar Disordes 4;
296–301, 2002.
23. Rodrigues JP, Edwards DJ, Walters SE,
Byrnes ML, Thickbroom G, Stell R, et al.
Gabapentin can improve postural stability
and quality of life in primary orthostatic
tremor. Mov Disord 20 (7); 865–886,
2005.

Thank you for copying data from http://www.arastirmax.com