Low Back Pain

Low back pain is a common complaint among some patients undergoing peritoneal dialysis (PD).  An increasing inward curvature of the spine (lordosis) can occur with increased intra-abdominal pressure and poor muscle tone, giving rise to sometimes severe discomfort in some patients.  The pain can result from paraspinal muscle spasm, sciatica, and posterior facet disease(1).

Treatment

General therapeutic measures include back exercises and judicious use of skeletal muscle relaxants and anti-inflammatory agents. Causes of low back pain unrelated to dialysis should be investigated. Specific measures for PD patients include decreasing the dialysate volume and transfer to automated peritoneal dialysis (APD), which reduces the daily exchange volume and subsequently the intra-abdominal pressure(2,3).  If all of these measures fail, transfer to hemodialysis may be required(2).

References

  1. Bargman JM. Complications of peritoneal dialysis related to increased intraabdominal pressure. Kidney Int Suppl. 1993;40:S75-S80. Available from: http://www.ncbi.nlm.nih.gov/pubmed/8445842.
  2. Mahale AS, Katyal A, Khanna R. Complications of peritoneal dialysis related to increased intra-abdominal pressure. Adv Perit Dial. 2003;19:130-135. Available from: http://www.ncbi.nlm.nih.gov/pubmed/14763049.
  3. Davies SJ, Wilkie ME. Complications of Peritoneal Dialysis. In: Johnson RJ, Feehally JD, Floege J, eds. Comprehensive Clinical Nephrology. 5th ed. Philadelphia, PA: Saunders Elsevier; 2015:1107-1115.

The information and reference materials contained in this document are intended solely for the general education of the reader. It is intended to provide pertinent data to assist you in forming your own conclusions and making decisions. This document should not be considered an endorsement of the information provided nor is it intended for treatment purposes and is not a substitute for professional evaluation and diagnosis. Additionally, this information is not intended to advocate any indication, dosage or other claim that is not covered, if applicable, in the FDA-approved label.

P/N 102505-01 Rev. A 06-2016