# The Significance of Palliative Care in Managing Pain for Patients Undergoing Hemodialysis

## TL;DR

Palliative care helps manage pain in hemodialysis patients, improving their quality of life by addressing pain triggers and using multidisciplinary approaches.

## Contribution

The study highlights the underutilization of palliative care and non-pharmacological methods in managing pain among hemodialysis patients in Hungary.

## Key findings

- 57% of hemodialysis patients reported pain, with 88% experiencing moderate-to-severe levels.
- Only 29% of patients achieved complete pain relief despite 64% using regular pain medication.
- Pain intensity was linked to factors like BMI, hypertension, diabetes, and PTH levels.

## Abstract

Background/Objectives: Pain is a common issue among patients undergoing hemodialysis (HD), and palliative care (PC) aims to improve their quality of life. This study investigates the incidence, nature, and treatment of pain in chronic HD patients in Hungary, along with factors influencing pain intensity and the benefits of PC. Methods: This study used a cross-sectional design involving 159 patients with chronic end-stage kidney disease (ESKD) receiving HD at the National Dialysis Center in Pécs, Hungary. Pain was assessed using a “PQRST” questionnaire, and statistical analyses were performed on clinical and laboratory data to identify potential pain triggers. We also reviewed the latest literature on PC for patients with ESKD undergoing HD. Results: Approximately 57% of patients reported pain, with 88% indicating moderate-to-severe pain levels. While 64% used regular pain medication, only 29% experienced complete pain relief. Non-pharmacological methods, along with adjuvant agents and strong notably different based on parathyroid opioids, were underutilized. Pain intensity was hormone (PTH) and C-reactive protein (CRP) levels. Key factors affecting pain included body mass index (BMI), hypertension (HT), diabetes mellitus (DM), and PTH levels. Research shows that PC is rarely used for patients on HD in many countries, despite being effective in managing symptoms. Conclusions: PC, along with pain assessment and multidisciplinary management, reduces the symptomatic burden for patients with ESKD. Effective management of mild pain should be handled by a nephrologist experienced in PC, while severe, therapy-resistant pain should be managed by PC specialists. Therefore, implementing PC is essential in the treatment of these patients.