The Significance of Palliative Care in Managing Pain for Patients Undergoing Hemodialysis

Background/Objectives: Pain is common among patients undergoing hemodialysis (HD), and palliative care (PC) aims to improve their quality of life. This study investigates the incidence, nature, and treatment of pain in chronic HD patients in Hungary, along with factors influencing pain intensity and the benefits of PC. Methods: A cross-sectional study involved 159 chronic end-stage kidney disease (ESKD) patients receiving HD at the National Dialysis Center in Pécs, Hungary. Pain was assessed using a “PQRST” questionnaire. Statistical analyses were per-formed on clinical and laboratory data to identify potential pain triggers. We also reviewed the latest literature on PC for patients with ESKD undergoing HD. Results: Approximately 57% of patients reported pain, with 88% indi-cating moderate to severe pain levels. While 64% used regular pain medication, only 29% experienced complete pain relief. Non-pharmacological methods, along with adjuvant agents and strong opioids were underutilized. Pain intensity was notably different based on parathyroid hormone (PTH) and C-reactive protein (CRP) levels. Key fac-tors affecting pain included body mass index (BMI), hypertension (HT), diabetes mellitus (DM), and PTH levels. Research shows that PC is rarely used for patients on HD in many countries, even though it is effective for manag-ing symptoms. Conclusion: PC, along with pain assessment and multidisciplinary management, reduces the symp-tomatic burden for patients with ESKD. Effective management of mild pain should be handled by a nephrologist experienced in PC, while severe, therapy-resistant pain should be managed by PC specialists. Therefore, imple-menting PC is essential in the treatment of these patients.