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Adults with chronic kidney failure (CKD) are not immune to the national opioid epidemic, suggests a research that will be presented at ASN Kidney Week 2018 from 23 to October 28 at the San Diego Convention Center.
Patients with CKD may be more likely to receive opioid prescriptions because of a high prevalence of pain and frequent contact with health care systems. In order to uncover trends in the use of prescription opioids among the population with chronic kidney failure, Daniel Murphy, MD (University of Minnesota) and his colleagues analyzed information from 1999 to 2014 on patients with chronic renal failure participating in the National Health and Nutrition Survey.
Between 1999 and 2014, adults with RCM in the United States were more likely to have an active prescription for an opioid drug and to use it, compared to those with no kidney failure (7.5% versus 5.4%). After statistical adjustment for demographic factors, a higher prevalence of prescription opioid use was also observed among people with RCMs in the years 2011-2014 compared to 1999-2002. No effect by race or ethnicity was observed, although the use of prescription opioids was higher in women and in the elderly.
The researchers also found that multiple comorbid conditions were associated with a higher prevalence of prescription opioids in patients with chronic kidney disease, including those who caused pain (such as cancer and arthritis), and than those who should not directly cause pain (such as diabetes, hypertension and obesity).
"Our research suggests the need for further work on the indications for opioid prescription and the results associated with the use of prescription opioids in patients with chronic kidney disease," said the Dr. Murphy.
Another study has shown that several environmental factors are associated with long-term prescription opioid use in elderly patients with chronic kidney disease. For the study, Yun Han, MD (University of Michigan) and colleagues analyzed a coupled data set from Medicare's 5% data on claims for benefits (2006-2009), the American Community Survey Data 2005-2009 and the Health Resources and Services Administration Data from the 2007 Primary Care Service Area.
The long-term average opioid consumption at the county level was higher in the western and southern counties than in the northeastern and midwestern counties. Counties with aging adults with a higher deprivation index tended to have greater long-term opioid use, as did counties in medically underserved areas.
"Our results underscore the importance of allocating resources to this epidemic at the county level.The environmental factors identified in our study can help health care providers to target patients with chronic high-risk renal disease." Opioid abuse / addiction, as well as the design of local regulations and treatments for appropriate use of opioids in patients with chronic kidney disease, "said Dr. Han.
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