Prevalence of Neuropathic Pain and Associated Risk Factors in Hemodialysis Patients: A Cross-Sectional Study

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Abstract
Objective: Chronic kidney disease (CKD) is associated with numerous systemic complications. Neuropathic pain is a significant neurological problem that affects quality of life. Neuropathic pain is an understudied complication in CKD patients undergoing hemodialysis treatment. In our study, we aimed to evaluate the prevalence of neuropathic pain in hemodialysis patients and the associated risk factors. Methods: This cross-sectional study was carried out at Ankara Etlik City Hospital between January and December 2024. We enrolled 141 adult patients who had been on maintenance hemodialysis for at least six months. Neuropathic pain was screened using the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale, with a cutoff score of ≥12 indicating neuropathic pain. Information on sociodemographic profile, clinical characteristics, dialysis duration, duration of chronic kidney disease, comorbid conditions, and lifestyle habits was systematically recorded. A multivariable logistic regression model was constructed to identify factors independently associated with the presence of neuropathic pain. Results: Neuropathic pain according to the LANSS scale was identified in 70 patients (49.6%). Patients with neuropathic pain had significantly longer hemodialysis duration (median 96 vs. 14 months, p < 0.001) and CKD duration (median 144 vs. 48 months, p < 0.001). Polypharmacy (67.1% vs. 39.4%, p = 0.001) and current smoking (40.0% vs. 16.9%, p = 0.002) were more common in the neuropathic pain group. Multivariate analysis revealed prolonged hemodialysis duration (OR 1.151, 95% CI 1.063–1.247, p < 0.001), longer CKD duration (OR 1.032, 95% CI 1.003–1.062, p = 0.047), polypharmacy (OR 9.06, 95% CI 5.536–15.322, p = 0.010), and smoking (OR 2.359, 95% CI 1.159–3.494, p = 0.024) as independent predictors. Conclusion: Neuropathic pain is highly prevalent among hemodialysis patients and is strongly associated with longer disease and treatment duration, polypharmacy, and smoking. Routine screening for neuropathic pain, which negatively impacts quality of life and clinical outcomes, should focus on modifiable risk factors such as careful medication management and smoking cessation.

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