Douleur chronique chez l’hémodialysé au Maroc

Béfa Noto-kadou-kaza, Kossi Akomola Sabi, Claude Mawufewo Tsevi, Benyounes Ramdani

Abstract


INTRODUCTION. En dépit des progrès réalisés ces dernières années dans la prise en charge de l’hémodialysé, la douleur chronique reste un problème préoccupant qui finit par altérer la qualité de vie. Sa prise en charge reste non codifiée.
OBJECTIF. Évaluer la prévalence, les facteurs de risque ainsi que la prise en charge de la douleur chronique chez l’hémodialysé au Maroc.
MÉTHODOLOGIE. Étude transversale (Décembre 2013) incluant 92 hémodialysés soumis à un questionnaire portant sur les caractéristiques de la douleur, son retentissement sur la vie quotidienne, les divers traitements. La douleur était chronique si elle persistait plus de 3 mois. L’intensité a été évaluée à l’aide de l’échelle visuelle analogique.
RÉSULTATS. Il y avait 56% de femmes et la moyenne d’âge était de 45±13 ans. La période moyenne de l’hémodialyse était de 163±74 mois. L’hyperparathyroïdie était retrouvée dans 60%. La prévalence de la douleur était de 51% et la durée moyenne de 43±29 mois. Elle était continue dans 27% des cas et survenait fréquemment dans 53% des cas. Son intensité était sévère dans 44% des cas. L’origine ostéoarticulaire était prédominante (72%). Elle retentissait sur l’activité quotidienne du patient dans 78% des cas. La prise en charge comportait des antalgiques dans 85% des cas et ceux de niveau 1 étaient utilisés dans 55% cas. Aucun patient n’était sous antalgique de niveau 3. La kinésithérapie a était réalisée dans 21%. En univariée, la douleur était significativement associée à l’hyperparathyroïdie secondaire (p=0,02).
CONCLUSION. La douleur chronique est non seulement fréquente mais elle retentit aussi sur la vie quotidienne des hémodialysés. Sa prise charge est inadéquate.
MOTS CLÉS. Douleur- Hémodialyse- Prévalence-Traitement

ABSTRACT
INTRODUCTION. Despite progress made in recent years in support of hemodialysis patient, chronic pain remains a problem that ultimately affects the quality of life. Its management remains uncodified.
AIM. To assess the prevalence, risk factors and the management of chronic pain patients receiving hemodialysis.
METHODOLOGY. Cross-sectional study (December 2013). 92 hemodialysis patients were subjected to a questionnaire on the characteristics of the pain, its impact on everyday life, the various treatments. The pain was chronic if it lasted for more than 3 months. The intensity was assessed using a visual analog scale.
RESULTS. 56% of patients were female and the mean age of 45 ± 13 years. The mean duration of hemodialysis was 163 ± 74 months. Hyperparathyroidism was found in 60% of cases. The prevalence of pain was 51% and its average duration was 43 ± 29 months. Pain was continuous in 27% of cases, frequent in 53% of cases. Its intensity was severe in 44% of cases. In 72% of cases, the origin was skeletal. She impacted negatively on the patient's daily activity in 78% of cases. The management was based analgesics in 85% of patients and level 1 analgesics were used in 55% of cases. No patient took level 3 analgesics. Physiotherapy was used in 21% of cases. Pain was significantly associated with secondary hyperparathyroidism (p = 0.02).
CONCLUSION. Chronic pain is not only common but it also affects the quality of daily life activities of hemodialysis patients. Its management is inadequate.
KEY WORDS: Pain-Hemodialysis-Prevalence-Management


Keywords


Douleur- Hémodialyse- Prévalence- Facteur de risque- Prise en charge

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