The Curbsiders Internal Medicine Podcast

REBOOT #146 Pain Meds in CKD

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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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