We tackle the complexities of pain management in patients with chronic kidney disease in this reboot from @NephMadness 2019 that, on a scale of 1-10, will leave you feeling very relieved in addressing pain. Topics: Opioids, gabapentinoids, NSAIDS, pain ladders, why tramadol is tramadont, and more! Get original show notes and podcast link here.
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Hi, Re. episode REBOOT #146 Pain Meds in CKD #NephMadness The guests in this episode mention that hydromophone doesn't have metabolically active/toxic metabolites but this doesn't appear to be true based on the literature and in practice. I am a palliative care physician and I routinely see hydromorphone cause opioid neurotoxicity especially in patients with renal impairment. See pub med links: https://pubmed.ncbi.nlm.nih.gov/27399959/ https://pubmed.ncbi.nlm.nih.gov/15353098/ It is my unerstanding that other than methadone which is not renally excreted, all the "traditional" opioids carry simialr risk for adverse effectes related to metabolites and should be used with caution and closely monitored in patients at risk of changing metabolism. Love your show! Thanks, Isaac
Great info Isaac! Thank you so much for listening!