REBOOT #146 Pain Meds in CKD

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! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME! 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 Sponsors:  Birch by Helix birchliving.com/curb for $200 off all mattresses and 2 free eco-rest pillows BetterHelp betterhelp.com/curb for 10% of your first month Indeed indeed.com/internalmedicine for a $75 sponsored job credit  Squarespace squarespace.com/curb offer code: CURB to save 10%