Gabapentin and Pregabalin Should Be Used Cautiously in Hemodialysis Patients

MedicalResearch.com Interview with:

Dr. Julie H. Ishida MD Department of Medicine, Division of Nephrology University of California, San Francisco and San Francisco Veterans Affairs Medical Center

Dr. Ishida

Dr. Julie H. Ishida MD
Department of Medicine, Division of Nephrology
University of California, San Francisco and
San Francisco Veterans Affairs Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Gabapentin and pregabalin are used for the management of symptoms such as neuropathic pain, itching, and restless leg syndrome in patients receiving hemodialysis. However, hemodialysis patients may be particularly vulnerable to adverse events related to these agents, which are cleared by the kidney, but there is limited data evaluating their risk in this population.

Gabapentin and pregabalin use were associated with risk for altered mental status, fall, and fracture, and in some cases, even at doses that would be considered safe for use in this population. 

MedicalResearch.com: What should readers take away from your report?

Response: Gabapentin and pregabalin should be used cautiously in patients receiving hemodialysis, and the lowest possible dose necessary to relieve symptoms should be prescribed.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Future research focused on mitigating the risk of these agents, including consideration of non-pharmacologic treatment modalities, is warranted. 

Disclosures: I would like to acknowledge that our data were supplied by the USRDS and that our work was supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases, National Institute on Aging, and the National Center for Advancing Translational Sciences. The authors do not have any disclosures to report. 

Citation:
Gabapentin and Pregabalin Use and Association with Adverse Outcomes among Hemodialysis Patients 

Julie H. Ishida, Charles E. McCulloch, Michael A. Steinman, Barbara A. Grimes, and Kirsten L. Johansen
JASN ASN.2018010096; published ahead of print June 5, 2018, doi:10.1681/ASN.2018010096

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