Because of the kidney’s important role in processing medications, those in renal failure may not be able to use many pain relievers.
Treatment for pain in people with chronic kidney disease and the more advanced stage of the disease, kidney failure, is not always easy. Kidney failure (also known as renal failure) and kidney disease cause decreased kidney function. Chronic kidney disease and renal failure are also more common in older adults. This population often has reduced kidney function, too.
This combination of circumstances makes treatment with opioids difficult. That’s largely due to the fact that the impaired kidneys cannot properly clean waste products from the blood. With opioid use, this can lead to a buildup of chemicals from the drugs. Ultimately, this buildup may become toxic.
In this article, we’ll learn more about the use of opioids in renal failure, including which drugs can be safely used and which need more monitoring.
Chronic use of these pain medications can lead to a buildup of toxic byproducts. This can cause acute kidney injury. Ultimately, it may lead to side effects like confusion, nausea, and swelling around the body.
That’s why it’s crucial that people with chronic kidney disease and renal failure work with their doctor for adequate and proper doses. This way, using these medications will not increase the risk of damage to the kidneys.
Opioid use in people with renal failure has to be monitored closely. Renal failure and kidney disease affect how the body absorbs and metabolizes medications. There can be complications for people with renal failure that others might not experience. This includes toxicity and possible overdose.
Still, doctors can prescribe opioid pain meds to patients who have renal failure. These include:
- Oxycodone: Oxycodone does not appear to cause toxic accumulations in people with renal failure. However, dosage adjustments may be required.
- Hydromorphone: This drug, too, may require dosage adjustments, but it’s considered safe to use in people with renal failure.
- Buprenorphine: This drug may be a good option because it produces fewer byproducts, but there isn’t as much data on its safety.
Follow your doctor’s prescription
Kidney disease and renal failure affect kidney function. Kidneys are responsible for breaking down and metabolizing medications. Therefore, people with kidney disease will experience different effects from medications than people with typical kidney function.
That’s why it’s important you follow your doctor’s instructions. Incorrect doses could cause side effects and serious issues like toxicity.
People with chronic kidney disease have additional pain medication options than people in renal failure. That’s because their kidneys likely function well enough to process medications.
Toxicity remains a risk, however. It’s important to follow your doctor’s dosage instructions.
Pain medications for people with poor kidney function
- Oxycodone: Dosage adjustments may be required to get to the safest possible dose.
- Fentanyl: This opioid may be safe for people with end-stage kidney disease, but it’s not appropriate for people in renal failure or undergoing hemodialysis.
- Methadone: This drug is less likely to cause accumulations in the blood that can lead to toxicity, so it’s considered safe for people with poor kidney function.
- Hydromorphone: This opioid is considered safe for people with both chronic kidney disease and renal failure.
- Buprenorphine: This drug is also less likely to cause toxic accumulations in the blood.
All of these drugs may require dosage adjustments to prevent toxic accumulations in the blood. Your doctor may prescribe greater intervals between doses to reduce the risk of overdose or toxic buildup.
People living with kidney disease and renal failure frequently experience chronic pain. Treatment for pain is possible.
Kidney disease impairs kidney function. In people with these conditions, the kidneys cannot process drugs in the same manner as they can if the kidneys were typical and healthy.
For that reason, doctors must carefully monitor people who have these conditions and take pain relievers. With proper treatment and careful monitoring, people with kidney disease and renal failure may be able to reduce their chronic pain and have a better quality of life.