Association between Multisite and Site-specific Chronic Pain, Analgesic Use, Metabolic-Proteomic Profile, and Incident Chronic Kidney Disease in Diabetes
Abstract
BACKGROUND: Although chronic pain is highly prevalent among individuals with diabetes, its relationship with the risk of developing chronic kidney disease (CKD) in this population remains poorly understood. The authors aimed to explore the associations between multisite chronic pain and analgesic use with CKD risk in people with diabetes, and to further characterize the underlying metabolic and proteomic signatures.
METHODS: The authors analyzed data from 20,208 UK Biobank participants with diabetes and complete chronic pain site information (headache, facial, neck/shoulder, back, stomach/abdominal, hip, knee). Using multivariable Cox regression models, they evaluated the prospective associations between chronic pain (both site specific and multisite), analgesic use (ibuprofen, paracetamol, opioid), and incident CKD risk. Multiomics data (248 metabolites, 2,911 proteins) were integrated to explore biological pathways.
RESULTS: During a median follow-up of 13.2 yr, 2,589 incident CKD cases were documented. Chronic pain was associated with an 18% higher CKD risk (adjusted hazard ratio [HR], 1.18; 95% CI, 1.08 to 1.28). Site-specific analysis identified significant associations between CKD risk and pain in neck/shoulder, back, hip, knee, and stomach/abdominal regions, while headache and facial pain showed no significant associations. Multisite pain exhibited a dose-dependent relationship with CKD risk (per additional site: adjusted HR, 1.08; 95% CI, 1.05 to 1.12). Among…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 20,208 participants or records.
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