Pain, Sleep Disturbance and Depression in Chronic Kidney Disease Patients

Abstract

Pain, depression, and sleep disorders are significant problems among CKD patients with varying degrees and intensities. In the current practice, little attention is paid to evaluate the prevalence and the causes of this problem with subsequent improper treatment of those patients. Pain is a multidimensional phenomenon with physical, psychological, and social components. Failure to treat pain adequately could be expected to lead to disruption in many aspects of life, such as functional status, mood and sleep. Accordingly, the present study was done to detect the prevalence of chronic pain, sleep disturbance, and depression in chronic kidney disease patients and possible predisposing factors. The study was conducted upon 200patients classified as follows: - 50 CKD patientsstage III. - 50 CKD patients stage IV. -50 CKD patients stage V. - 50 CKD patients stage V d. All patients were thoroughly interrogated and examined clinically, and were subjected to VON KORFF questionnaire, PITTSBURG SLEEP QUAILTY INDEX, Beck Depression Inventory, measurement ofhemoglobin level (HB), serum albumin, serum creatinine, blood urea, serum Calcium (Ca), serum phosphorus (PO4), serum uric acid (UA), serum intact Parathormone (PTH), Ca XPo4 products, then data were collected and statistically analyzed. Based on the result of the current study it can be concluded that severity of chronic pain increases with conservative CKD management starting from stage 3-5, with highest severpain percentage in stage 5, while patients on dialysis appear to have least sever chronic pain in comparable to stage 5 and 4. There was significant positive correlation between serum uric acid and chronic pain, Painin our study was independently associated with higher PSQI (poor sleep) and higher BDIscore (more depression). With conservative CKDmanagement sleep quality worsening start from stage 3-5 with highest worst in stage 5, but with initiation of dialysis we found less poor sleep in stage 5D in comparable with stage 5and 4.