Pain assessment in adult patients in a hemodialysis program at a tertiary hospital in Mexico

A single-center observational study.

Abstract

Introduction: Pain is one of the most frequent and disabling symptoms in chronic kidney disease patients undergoing hemodialysis. However, its systematic evaluation and treatment remain limited, particularly in the Mexican context. The aim of this study was to describe the prevalence of pain and its clinical characteristics in Mexican adult patients in hemodialysis programs in a tertiary level specialty hospital.

Material and methods: Cross-sectional study in patients receiving treatment in the hemodialysis program at the High Specialty Medical Unit No. 71 of the Mexican Institute of Social Security, during the period from January to March 2025. Two validated instruments were personally applied in Spanish: the Brief Pain Questionnaire and the Spanish Pain Questionnaire. Sixty-seven patients over 18 years of age in the conventional hemodialysis program were included. Sociodemographic, clinical and pain experience related variables were analyzed.

Results: 76% of patients reported pain, predominantly somatic (50.98%) and mixed (47.05%). The most frequent locations were lower limbs (68.62%), back (43.13%) and head (35.29%). Pain had a significant impact on general activities, mood and mobility. Non-opioid analgesics, mainly paracetamol, were used by 82.35%, but 43.13% reported limited relief (10-40%). All patients expressed concern about side effects and expressed a need for more information on pain management.

Conclusion: Pain in hemodialysis patients represents a highly prevalent problem, poorly controlled and with a significant functional impact. It is essential to implement a systematic evaluation, design individualized management strategies and strengthen the education of both patients and health personnel to improve their comprehensive approach.