Patients with advanced kidney disease experience significant symptoms that are often undertreated, and preliminary evidence suggests cannabinoids could help with pain, nausea, appetite loss, and itching.
Nephrologists, dialysis patients, medical cannabis researchers.
Four common symptoms in advanced kidney disease - pain, nausea, appetite loss, and itching - may respond to cannabinoid treatment based on evidence from other populations.
What the researchers found
The review found emerging evidence supporting potential benefits of medical marijuana for four common symptoms in advanced CKD and dialysis patients: chronic pain, nausea/vomiting, anorexia/cachexia, and pruritus (itching). The endocannabinoid system appears to play a role in kidney function and disease.
Why it matters
Patients on dialysis often suffer from symptoms that are difficult to treat with conventional medications due to altered drug metabolism and increased side effect risk. Cannabinoids represent a potential alternative, especially as legal access expands.
The numbers in context
29 US states had medical marijuana programs at time of publication. CKD/ESRD patients experience chronic pain, nausea, appetite loss, and itching at rates far exceeding the general population.
How the study worked
Narrative review of available evidence on medical marijuana use for symptom management in chronic kidney disease and end-stage renal disease.
What this study cannot tell us
Narrative review based on limited direct evidence in CKD/ESRD populations. Most cannabinoid research has been in other patient populations. No clinical trials specific to kidney disease patients were available.
How to read the evidence
Preliminary - narrative review largely extrapolating from non-kidney-disease populations with limited direct evidence.
When this study was published
Published in 2018. Cannabis research in kidney disease remains an emerging field.
The bigger picture
As more patients with kidney disease live longer on dialysis, symptom management becomes increasingly important for quality of life. Cannabinoids could fill a therapeutic gap, but the altered pharmacokinetics in kidney disease make careful research essential.
Questions still open
- How is cannabinoid metabolism affected by impaired kidney function? Are there specific dosing considerations for dialysis patients? Could cannabinoids interact with common medications used in CKD?
Common questions
Can cannabis help with kidney disease symptoms?
Is cannabis safe for people on dialysis?
Read the original research
Marijuana and Cannabinoids in ESRD and Earlier Stages of CKD.
American journal of kidney diseases : the official journal of the National Kidney Foundation, 71(2), 267-274
Citation
Rein, Joshua L; Wyatt, Christina M. (2018). Marijuana and Cannabinoids in ESRD and Earlier Stages of CKD.. American journal of kidney diseases : the official journal of the National Kidney Foundation, 71(2), 267-274. https://doi.org/10.1053/j.ajkd.2017.06.020
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