Comparison of uremic pruritus between patients undergoing hemodialysis and peritoneal dialysis

Min, Ji Won; Kim, Su Hyun; Kim, Young Ok; Jin, Dong Chan; Song, Ho Chul; Choi, Euy Jin; Kim, Yong Lim; Kim, Yon Su; Kang, Shin Wook; Kim, Nam Ho; Yang, Chul Woo; Kim, Yong Kyun

doi:10.1016/j.krcp.2016.02.002

Cited by 55 publications

(70 citation statements)

References 18 publications

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“…With regards to UP characteristics, our results found that severe pruritus was observed in the studied population, as represented by a median VAS of 7 (5-8), according to the adopted classification in previous studies [9,17,20]. It is important to note that some studies have found an increased mortality risk in patients undergoing dialysis associated with severe pruritus, e.g., when the pruritus VAS score was greater than 7 [17,21].…”

Section: Discussionsupporting

confidence: 53%

“…When comparing UP prevalence in patients undergoing HD or peritoneal dialysis, Min et al [9] found a greater prevalence among those who underwent peritoneal dialysis compared to HD and ascribed this finding to the fact that these patients did not use high-flux dialyzers; thus, average-sized inflammatory molecules were not removed. Dialysis adequacy has a fundamental role in metabolic control and the clearance of possible pruritogenic substances, which may result in the attenuation of UP-associated factors.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that in CKD, UP can be related to skin xerosis, secundary hyperparathyroidism, anemia, inadequate dialysis, mast cell proliferation and degranulation, pruritogenic cytokines (histamine, kallikrein, and interleukin-2), divalent iron metabolism, sudorese reduction, an abnormal pattern of cutaneous innervation and psychogenic elements secondary to chronic disease stress [6,7]. Other studies have cited a possible relation between the accumulation of uremic toxins and inflammatory molecules of average and large molecular weight, such as β2-microglobulin, in the etiology of UP [8,9].…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with uremic pruritus

et al. 2017

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Background: The etiopathogenesis of uremic pruritus (UP) is multifactorial aspect, and it is thus necessary to elucidate its associated factors to develop efficient therapeutics approaches. This study aimed to verify the prevalence of UP and its associated factors. Methods and Findings:Prospective and cross-sectional study with patients undergoing hemodialysis at a university public hospital. The data were obtained between April 2014 and April 2015. The statistical analysis was carried out using multivariate regression models, and statistical significance was set at p<0.05. A total of 164 patients were included, and pruritus was reported in 64 (39%). In the multivariate analysis, a higher creatinine level was risk factor for pruritus (β=1.09, 95% CI 1.00-1.19; p=0.048), as was a lower level of hemoglobin (β=0.85, 95% CI 0.73-0.99; p=0.043). Dyslipidemia (β=1.52, 95% CI 0.12-2.91; p=0.03), obesity (β=2.40, 95% CI 1.03-3.78; p=0.001), higher levels of C-reactive protein (β=0.26, 95% CI 0.19-0.34; p<0.001) and black race (β=1.49, 95% CI -2.57 and 0.42; p<0.006) were associated with a greater intensity of pruritus. The use of a high-flux dialyzer was associated with a lower intensity of pruritus (β=-1.69, 95% CI -3.05-0.34; p=0.01). Conclusion:Uremic pruritus has a high prevalence in hemodialysis patients, and the data suggest that the higher the creatinine and the lower the hemoglobin levels are, the greater the risk of developing pruritus is. Dyslipidemia, obesity, and higher levels of C-reactive protein were associated with a greater intensity of pruritus, whereas the use of a high-flux dialyzer was associated with lower pruritus intensity.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors associated with uremic pruritus

et al. 2017

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“…21 In a cross-sectional study of 223 PD and 425 HD patients from Korea, the prevalence of at least mild pruritus was 62.5% in HD patients and 48.3% in PD patients. 22 Several studies have compared CKD-aP prevalence rates in HD and PD patients with mixed results. Two studies found no difference in pruritus rates, 23,24 whereas one study found higher rates of pruritus in PD patients, 22 and one found higher rates of pruritus in HD patients.…”

mentioning

confidence: 99%

“…22 Several studies have compared CKD-aP prevalence rates in HD and PD patients with mixed results. Two studies found no difference in pruritus rates, 23,24 whereas one study found higher rates of pruritus in PD patients, 22 and one found higher rates of pruritus in HD patients. 25 These mixed results are likely due to the varied study populations and the different instruments used to measure CKD-aP in these studies.…”

mentioning

confidence: 99%

Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges

Shirazian¹,

Aina²,

Park³

et al. 2017

IJNRD

111

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Chronic kidney disease-associated pruritus (CKD-aP) is a distressing, often overlooked condition in patients with CKD and end-stage renal disease. It affects ~40% of patients with end-stage renal disease and has been associated with poor quality of life, poor sleep, depression, and mortality. Prevalence estimates vary based on the instruments used to diagnose CKD-aP, and standardized diagnostic instruments are sorely needed. Treatment studies have often yielded conflicting results. This is likely related to studies that are limited by small sample size, flawed designs, and nonstandardized diagnostic instruments. Several large well-designed treatment trials have recently been completed and may soon influence CKD-aP management.

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