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Pain is one of the most common and distressing symptoms among patients with chronic kidney disease (CKD) . The prevalence of pain has been associated with substantially lower health-related quality of life and greater psychosocial distress, insomnia, and depressive symptoms [ 2-9 ]. Common in People with Kidney Disease? • Pain is more common in CKD patients than in the general population. Over 60% of hemodialysis patients describe moderate or severe chronic pain (Davison, 2019) • Half of dialysis patients experience moderate or severe pain (Santoro et al., 2012) and (Raina et al., 2018) Gabapentin and pregabalin are often used in patients with CKD primarily to treat neuropathic pain and restless leg syndrome and given the high prevalence of diabetes in this population, the proportion who receive these drugs is very high. Gabapentin (Neurontin) usually isn’t bad for your liver or kidneys. In most cases, it has little effect on these organs. In rare instances, gabapentin can cause DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome. Challenges in pain management in patients with kidney disease. Pain assessment. This should start with assessment of a) pain severity using various standardized tools, most common of which is the numerical rating scale []; b) pathophysiologic evaluatio n into mechanism of injury and type of pain; c) psychosocial evaluation of co-occurring factors that contribute to pain or make treatment of Gabapentinoids are opioid substitutes whose elimination by the kidneys is reduced as kidney function declines. To inform their safe prescribing in older adults with chronic kidney disease (CKD), we examined the 30-day risk of serious adverse events according to the prescribed starting dose. The question of whether gabapentin is safe for cats with chronic kidney disease (CKD) is complex and requires careful consideration. The short answer is: it can be safe when used judiciously, but it’s not without risks and requires dosage adjustments due to the kidneys’ role in its elimination. Professional #2, a veterinary pharmacist, adds, “Customized dosing of gabapentin is essential in cats with kidney disease to ensure optimal efficacy and safety. Working closely with veterinarians, we can tailor dosages to meet the individual needs of each feline patient.” Rationale & objective: Gabapentinoids are opioid substitutes whose elimination by the kidneys is reduced as kidney function declines. To inform their safe prescribing in older adults with chronic kidney disease (CKD), we examined the 30-day risk of serious adverse events according to the prescribed starting dose. In summary, gabapentin can be used in patients with stage 3 kidney disease, but only under careful medical supervision and with appropriate dosage adjustments. Never attempt to self-medicate or adjust dosages without consulting your doctor. Majority drugs, including Gabapentin, are eliminated by the kidneys and will accumulate to a toxic level in renally compromised patients as in this case. Per Lexicomp, Gabapentin’s recommended dose in patients with renal impairment is as follows: CrCl >15 to 29 mL/minute: 200 to 700 mg once daily. CrCl 15 mL/minute: 100 to 300 mg once daily Pain is one of the most common and distressing symptoms for people with chronic kidney disease (CKD). Take care when choosing a painkiller (analgesic) as some types should not be taken by people with kidney problems or should only be used with specialist guidance. Gabapentin is actually toxic to the kidneys. Gabapentin is frequently used as an analgesic in patients with chronic kidney disease. Although gabapentin is well known for its well recieved pharmacokinetics, it is exclusively eliminated renally, and patients with chronic kidney disease are at risk for toxicity. Patients with chronic kidney disease often receive inappropriately high gabapentin dosage for their kidney function, occasioning overt toxicity; advanced age and comorbidity predispose these patients for toxicity. The short answer is: yes, gabapentin can be problematic for individuals with kidney failure and chronic kidney disease (CKD). While gabapentin is often prescribed for pain management, particularly nerve pain, and sometimes for seizures, its primary elimination pathway is through the kidneys. Gabapentin and pregabalin are commonly used for neuropathic pain in CKD patients but are not fully understood as this population remains excluded from efficacy and safety trials. Renal adjustments for the gabapentinoids are prodigiously recommended in the literature. Gabapentin is frequently used as an analgesic in patients with chronic kidney disease. Although gabapentin is well known for its favorable pharmacokinetics, it is exclusively eliminated renally, and patients with chronic kidney disease are at risk for toxicity. Existing literature on such risk is lacking. Although gabapentin is well known for its favorable pharmacokinetics, it is exclusively eliminated renally, and patients with chronic kidney disease are at risk for toxicity. Existing literature on such risk is lacking. The 20 mg/kg stress-reduction dose of gabapentin may be beneficial to facilitate preventive veterinary care in younger, healthy cats, but this dose may be inappropriate for elderly cats, specifically those with chronic kidney disease (CKD). Gabapentin is not metabolized or protein bound, and is cleared only by renal excretion in humans; it is
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