Daniela Pogliani
ASST Valle Olona UO Nefrologia e Dialisi, Italy
: J Kidney
The management of the pain therapy (ischemic pain, neoplastic pain) in hemodialysis patients has become a frequent challenge in the last years. These patients often require the prescription of major analgesic drugs such as opioids like Fentanyl, in order to control the pain. It is necessary to pay attention to the correct dosage and to the half-life of these drugs that results prolonged in the chronic renal insufficiency. The main side effect of opioids is respiratory depression and is well known, but to date in the literature reports about other less frequent side effects, like epilepsy or status epilepticus are lacking. We report two cases of chronic hemodialysed patients who developed a generalized non-convulsive status epilepticus secondary to fentanyl intoxication administered for the pain therapy. These cases required a synergic team management implicating the nephrologists, the neurologist and the intensivist. The generalized non-convulsive status epilepticus could be an important and serious side effect of fentanyl in hemodialysis patients and it is therefore necessary a sharp monitoring of the pain therapy in these subjects.
Daniela Pogliani has completed her MD from Università Milano-Bicocca, Milan and Post-doctoral studies from the same university. She is specialized in Nephrology. She currently works in a Nephrology and Dialysis Unit in a Public Hospital, Gallarate, Italy. She has been co-author of up to 11 papers in reputed journals and is a Member of the Editorial Board of the Giornale Italiano di Nefrologia.
