Is There a Legitimate Role for the Therapeutic Use of Cannabinoids for Symptom Management in Chronic Kidney Disease?

Chronic pain is a common and debilitating symptom experienced in the context of numerous other physical and emotional symptoms by many patients with chronic kidney disease (CKD). Management of pain with opioids in CKD can be problematic given the prominence of adverse effects of opioids in CKD, which may exacerbate symptoms, such as nausea, anorexia, pruritus, and insomnia, all of which impact negatively on patients' health-related quality of life. Novel therapeutic approaches for pain and symptom management in CKD are required. Recent research in the area of cannabinoids (CBs) is legitimizing the use of cannabis-based medicine. In this review, we describe the symptom burden borne by patients with CKD and review some of the key basic science and clinical literature to evaluate the potential use of CBs for the management of overall symptom burden in CKD. J Pain Symptom Manage 2011; 41: 768-778. (c) 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.