Abstract
Context
The efficacy and safety of cannabinoids to treat symptoms in individuals with kidney
disease is uncertain.
Objectives
We sought to elicit Canadian nephrologists' views regarding the use and study of cannabinoids
in patients with kidney disease in an Internet-based survey of Canadian of Society
of Nephrology members treating adult patients with kidney disease including dialysis.
Methods
The degree to which respondents supported the use or study of cannabinoids for symptoms
common in kidney disease was assessed using a modified Likert scale ranging from 1
to 7 (anchored at 1—definitely would not and 7—being definitely would). Participants
were asked their degree of support for cannabinoid use in clinical practice and for
randomized controlled trials examining cannabinoids for anxiety, depression, restless
legs syndrome, itchiness, fatigue, chronic pain, decreased appetite, nausea/vomiting,
sleep disorder, and others. Multilevel multivariable linear regression was used to
identify independent predictors of the degree of support.
Results
There were 151 (43.4%) responses from 348 eligible participants. One hundred twenty-four
(82%) previously cared for patients using prescribed cannabinoids by other providers,
and 29 (19%) had previously prescribed cannabinoids themselves. One hundred thirty-seven
(91%) had previously cared for patients using nonprescription cannabinoids, which
were used most commonly recreationally (88.3%), for chronic pain (73.7%) or for anxiety
(52.6%). Respondents supported the use of cannabinoids (mean score >5) for each symptom
in the setting of refractory symptoms. Similarly, respondents supported enrolling
patients for trials for all symptoms (mean scores >5).
Conclusion
Nephrologists broadly support the use and study of cannabinoids for symptoms in patients
with kidney disease.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Pain and Symptom ManagementAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The prevalence of symptoms in end-stage renal disease: a systematic review.Adv Chronic Kidney Dis. 2007; 14: 82-99
- Renal provider recognition of symptoms in patients on maintenance hemodialysis.Clin J Am Soc Nephrol. 2007; 2: 960-967
- Symptoms in advanced renal disease: a cross-sectional survey of symptom prevalence in stage 5 chronic kidney disease managed without dialysis.J Palliat Med. 2007; 10: 1266-1276
- Setting research priorities for patients on or nearing dialysis.Clin J Am Soc Nephrol. 2014; 9: 1813-1821
- Treatment of uremic pruritus: a systematic review.Am J Kidney Dis. 2017; 70: 638-655
- Interventions for improving sleep quality in people with chronic kidney disease.Cochrane Database Syst Rev. 2019; 5: CD012625
- Pain in chronic kidney disease: a scoping review.Semin Dial. 2014; 27: 188-204
- Interventions for chronic kidney disease-associated restless legs syndrome.Cochrane Database Syst Rev. 2016; 11: CD010690
- Marijuana and cannabinoids in ESRD and earlier stages of CKD.Am J Kidney Dis. 2018; 71: 267-274
- A review of cannabis in chronic kidney disease symptom management.Can J Kidney Health Dis. 2019; 6 (2054358119828391)
- Cannabis-based medicines for chronic neuropathic pain in adults.Cochrane Database Syst Rev. 2018; 3: CD012182
- Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy.Cochrane Database Syst Rev. 2015; 11: CD009464
- The medical use of cannabis for reducing morbidity and mortality in patients with HIV/AIDS.Cochrane Database Syst Rev. 2013; 4: CD005175
- The diverse CB1 and CB2 receptor pharmacology of three plant cannabinoids: delta9-tetrahydrocannabinol, cannabidiol and delta9-tetrahydrocannabivarin.Br J Pharmacol. 2008; 153: 199-215
- Cannabinoids and pain: sites and mechanisms of action.Adv Pharmacol. 2017; 80: 437-475
- Mechanisms of broad-spectrum antiemetic efficacy of cannabinoids against chemotherapy-induced acute and delayed vomiting.Pharmaceuticals (Basel). 2010; 3: 2930-2955
- Cannabinoids for medical use: a systematic review and meta-analysis.JAMA. 2015; 313: 2456-2473
- Likert scales, levels of measurement and the “laws” of statistics.Adv Health Sci Educ Theor Pract. 2010; 15: 625-632
- Stepwise selection in small data sets: a simulation study of bias in logistic regression analysis.J Clin Epidemiol. 1999; 52: 935-942
- The number of subjects per variable required in linear regression analyses.J Clin Epidemiol. 2015; 68: 627-636
- New York physicians' perspectives and knowledge of the State Medical Marijuana Program.Cannabis Cannabinoid Res. 2018; 3: 74-84
- Oncology clinicians and the Minnesota Medical Cannabis Program: a survey on medical cannabis practice patterns, barriers to enrollment, and educational needs.Cannabis Cannabinoid Res. 2018; 3: 195-202
- Knowledge, practices, and attitudes of Washington state health care professionals regarding medical cannabis.Cannabis Cannabinoid Res. 2020; 5: 172-182
- Pharmacokinetics and pharmacodynamics of cannabinoids.Clin Pharmacokinet. 2003; 42: 327-360
- The pharmacokinetics and the pharmacodynamics of cannabinoids.Br J Clin Pharmacol. 2018; 84: 2477-2482
- Adverse effects of medical cannabinoids: a systematic review.CMAJ. 2008; 178: 1669-1678
- Gaps in predicting clinical doses for cannabinoids therapy: overview of issues for pharmacokinetics and pharmacodynamics modelling.Br J Clin Pharmacol. 2018; 84: 2483-2487
- Patient-reported use of medical cannabis for pain, anxiety, and depression symptoms: systematic review and meta-analysis.Soc Sci Med. 2019; 233: 181-192
- Gabapentin and pregabalin use and association with adverse outcomes among hemodialysis patients.J Am Soc Nephrol. 2018; 29: 1970-1978
- Opioid analgesics and adverse outcomes among hemodialysis patients.Clin J Am Soc Nephrol. 2018; 13: 746-753
- Is cannabis treatment for anxiety, mood, and related disorders ready for prime time?.Depress Anxiety. 2017; 34: 1006-1017
- The effects of cannabinoid administration on sleep: a systematic review of human studies.Sleep Med Rev. 2014; 18: 477-487
- Cannabinoids in dermatology: a scoping review.Dermatol Online J. 2018; 24 (13030/qt7pn8c0sb)
- Cannabis for restless legs syndrome: a report of six patients.Sleep Med. 2017; 36: 182-183
- The pharmacologic and clinical effects of medical cannabis.Pharmacotherapy. 2013; 33: 195-209
- Most nephrologists are primary care providers for chronic dialysis patients: results of a national survey.Am J Kidney Dis. 1996; 28: 67-71
Article info
Publication history
Published online: August 13, 2020
Accepted:
August 7,
2020
Identification
Copyright
© 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
