Overview

P t nt with chronic k dn d (CKD) h v limited l f expectancy: the t m t d r du l l f n approximately 8 t 4.5 years after dialysis n t t n f r those g d 40 t 64 r , respectively. C n u ntl , t m z ng quality of l f (QOL) is f h gh priority. Unfortunately, t nt r often ffl t d w th numerous m t m , w th n cross-sectional study r rt ng n v r g f 13 m t m experienced b t nt with stage 4 CKD nd b v . S m t m burden nd QOL f nd- t g r n l d (ESRD) h v l been compared with th t of t rm n l malignancy3 nd mm nl experienced m t m u h as pain, n u , anxiety, and n mn r m n significantly undertreated, w th nl 20% t 60% f t nt w th CKD receiving tr tm nt. C nv nt n l h rm l g l agents x t, but dv r ff t , intolerances, r fr t r nd t n , and h v ll burd n n l m t their use. In t g 5 CKD, rl ntr ll d ur m m t m are managed with th n t t n of d l . Nonetheless, m r d w th l t d l n t t n, early dialysis n t t n n r gr v CKD has b n t d w th h gh r d l t w th ut improving survival r v r ll QOL. Following l g l z t n in Canada, ft n ng of social attitudes nd reduced stigmatism t w rd nn b u x t d t g rn r n r d nt r t n m d l nn b , especially f r chronic r fr t r m t m nd palliative conditions such th observed n patients w th CKD. W th expanded cannabis access thr ugh l n d r t l r and lf-gr wn l nt , lf-m d t ng f cannabis w ll also become n v t bl m ng some t nt w th suboptimal m t m control. T m n m z th r k f dv r drug ff t nd potential f r ub t n abuse, t is paramount that l n n r able t r v d v d n -b d guidance nd du t n t patients to m k w ll- nf rm d d n . H w v r, ur understanding of th ff t f cannabis n patients w th CKD and its role in symptom m n g m nt remains limited. In th rt l , w m t review the b n f t nd risks f nn b u n th ul t n and, wh r v l bl , t bl h v d n -b d nd t n of cannabis f r CKD-r l t d m t m management. Du to l m t d tr tm nt t n , symptom management in t nt with CKD n be h ll ng ng, nd th r f r th r ut alternatives r n h gh d m nd. In recent r , medical m r ju n h m rg d n ttr t v therapeutic t n, but nt nu to be u d f r a variety of unsubstantiated indications w th minimal gu d n on kn wn risks, rt ul rl w th r t t the altered physiological state f patients with CKD. At this time, th u rt v v d n f r u ng nonsynthetic nn b n d for m t m m n g m nt is limited t th tr tm nt f hr n n ur th n, w th r m ng t nt l when used topically f r th tr tm nt f uremic pruritus. Cl n n n d t be gn z nt th t n n nth t nn b n d , particularly smoked nn b , significant health r k wh h mu t be ut u l weighed g n t th limited ub t nt t d therapeutic benefits f cannabis.

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