Researcher tackles opioid use among kidney disease patients

Opiod pill bottles

Many end-stage kidney disease patients on chronic dialysis are in pain, and opioids have become the go-to strategy to manage that pain. Up to two-thirds of dialysis patients receive opioids – three times higher than the general population.

With a nearly $3.9 million grant from the National Institutes of Health, an interprofessional team led by UIC Nursing Collegiate Professor Ardith Doorenbos, PhD, RN, FAAN, and UIC associate professor of medicine Michael Fischer is seeking alternate pain-management strategies that don’t involve opioids. What they learn could have a ripple effect on other populations affected by the opioid epidemic.

“What we’re hoping to be able to do is take a look at how we can reduce the amount of opioids prescribed in the hemodialysis population,” Doorenbos says. “We want to be more mindful and concerned about the opioids they are on so we can give them better quality of life.”

End-stage renal disease is a severe loss of kidney function. There is no cure, but with dialysis and the right support, patients can live for years. However, Doorenbos says opioid use can diminish the quality and hasten the end of a patient’s life. Opioids have been associated with an increased risk of falls, impaired cognition, hospitalization and death.

Over the course of the five-year study, researchers will enroll 720 chronic dialysis patients across a number of U.S. clinical centers.

They’ll be exploring two strategies: The first is to manage the pain without any medication by using approaches such as cognitive behavioral therapy, which will give patients self-management skills to manage pain “before they turn to the pill bottle,” Doorenbos says. This could include sleep hygiene strategies because poor sleep is associated with pain, she says.

The second is to switch the patients to buprenorphine, a medication management tool that has been found to both treat opioid disorders and improve pain.

“If effective, we’re hopeful these non-pharmacological strategies could be applicable beyond kidney disease patients to other populations affected by the opioid epidemic,” Doorenbos says.