Pain, sleep disturbance, and quality of life in patients with chronic kidney disease.

BACKGROUND AND OBJECTIVES Few studies have assessed sleep disturbances or perception of pain in patients with early-stage chronic kidney disease. It was hypothesized that perception of pain and sleep disturbance would increase with chronic kidney disease stage, that pain and sleep disturbance would correlate with psychosocial variables, and that there would be a higher prevalence of pain and sleep disturbances in patients with chronic kidney disease compared with general medical patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS A total of 92 predialysis patients with chronic kidney disease and 61 general medical outpatients were evaluated using the Beck Depression Inventory, Illness Effects Questionnaire, Multidimensional Scale of Perceived Social Support, Satisfaction with Life Scale, Karnofsky Scale, Pittsburgh Sleep Questionnaire, and McGill Pain questionnaire. RESULTS With the exception of expected differences in serum creatinine, estimated GFR, Karnofsky score, albumin, and hemoglobin, there were no significant differences between groups. A total of 69% of patients with chronic kidney disease experienced pain; 55.2% had disordered sleep. Pain was associated with quality-of-life indicators, including depression, burden of illness, and life satisfaction. Disordered sleep correlated with depression, illness burden, social support, and pain frequency. There were no differences in perception of pain or sleep disturbance between patients with chronic kidney disease and control patients. CONCLUSIONS Pain is common in patients with early-stage chronic kidney disease and is associated with patients' perception of lower quality of life. The prevalence of pain, sleep disturbance, and abnormal psychologic status of patients with chronic kidney disease may be similar to outpatients with other chronic medical illnesses.