REBOOT #146 Pain Meds in CKD

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!
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Credits

• Written and produced by: Justin Berk MD
• NephMadness Pain Region: Samantha Gelfand MD
• NephMadness Pun Contest produced by: Hannah R Abrams
• Cover art by: Kate Grant MBChB, Dip GUMed
• Hosts: Matthew Watto MD, Paul Williams MD, Stuart Brigham MD
• Edited by: Matthew Watto MD (audio), Emi Okamoto MD (show notes)
• Guests:  Samantha Gelfand MD, Matthew Sparks MD, David Juurlink MD

Show Segments

• Kidney Pun
• Disclaimer, intro and guest bios
• Guest one-liners
• Clinical Case and Pain Management Disclaimer
• Modalities for pain meds in ckd
• Opioids for pain and their metabolites
• Dave Juurlink reframes the question, “what is our real goal with pain management?”
• Matt Sparks reiterates the dangers of morphine and codeine in patients with advanced CKD
• Communicating meds that are contraindicated or relatively contraindicated in CKD
• Buprenorphine
• What about the WHO Pain Ladder for CKD?
• Should we use more cannabinoids? Ketamine?
• Dave Juurlink rants on Tramadol
• NSAIDS and CKD
• Gabapentinoids (gabapentin and pregabalin) for neuropathic pain and driving?!
• Estimating eGFR in CKD and AKI. Which equation is best?
• How would each of our experts treat this patient with CKD and knee pain
• Outro

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