<p>Factors Associated with Uremic Pruritus in Patients Undergoing Peritoneal Dialysis</p>

Abstract

Aim: The aim of this study was to investigate different intensities of uremic pruritus in the daytime and nighttime, as well as contributing factors, in patients undergoing peritoneal dialysis (PD). Methods: A total of 46 patients (31 males, 15 females) with a mean age of 59.4±14.7 years and mean PD vintage of 29.2±25.2 months were enrolled in this single-center, prospective, cross-sectional study. The intensity of uremic pruritus in the daytime and nighttime was assessed using a visual analog scale (VAS). The relationships between intensity and various clinical and laboratory parameters were analyzed using multiple linear regression analyses. Results: The most common site of uremic pruritus was on the back (70%), followed by lower limbs (67%), chest and abdomen (59%), upper limbs (28%), and head and neck (22%). Mean VAS scores were higher in the nighttime compared with the daytime (4.5±3.3 vs. 3.5 ±2.7, P=0.02). Only male sex was correlated with higher uremic pruritus intensity in the daytime (standard coefficient [β]=0.310, P=0.036). PD vintage (β=0.415, P=0.004) and topical medicines, including moisturizer and topical corticosteroid use (β=0.345, P=0.019), were independently correlated with higher uremic pruritus intensity in the nighttime. Conclusion: Uremic pruritus intensity was greater in the nighttime than in the daytime in PD patients. Male sex was associated with higher uremic pruritus intensity in the daytime, whereas PD vintage and topical medicine use were associated with higher uremic pruritus intensity in the nighttime.

Chronic Intractable Pruritus in Chronic Kidney Disease Patients: Prevalence, Impact, and Management Challenges — A Narrative Review

“…92 Mathur et al 90 showed that mean worst itching intensity for enrolled patients was 59.9 mm using the 100 mm VAS. Scores were significantly higher for the 12-hour nighttime period than for the 12-hour daytime period, which corresponds with the research on patients undergoing PD conducted by Minato et al 95 Additionally, in DOPPS, a third of patients were most bothered by itch at night. 13 Apart from the time of day, there are many other factors that can affect the course of itch.…”

The Role of Dysbiosis in Critically Ill Patients With COVID-19 and Acute Respiratory Distress Syndrome

“…Oral delivery of human ACE2 through the probiotic species Lactobacillus paracasei increased ACE activity in the serum and tissues of mice. Similar results can be obtained with the bacteria-derived B38-CAP enzyme (147,148). Recent research highlighted the role of mucin biopolymers as pivotal in regulating mucin production, which is implied in viral replication in the gut.…”

Serum thymus and activation-regulated chemokine level is associated with the severity of chronic kidney disease-associated pruritus in patients undergoing peritoneal dialysis

“…There are limited studies on CKD-aP-related predictors in patients with PD, and the results were inconsistent across studies. 5,13,27,28 Therefore, among potential predictors that have been previously reported to be associated with CKD-aP in patients undergoing HD or PD (age, sex, diabetes mellitus (DM), dialysis vintage, WCSC, renal Kt/V, peritoneal Kt/V, total Kt/V, urine output, creatinine, urea nitrogen, Hb, ferritin, calcium, phosphorus, calcium-phosphorus product, β 2 microglobulin, α 1 microglobulin, C-reactive protein and BNP), variables with p < 0.2 in univariate linear regression analysis of VAS scores were also included. 1,3 –8,10 –13,27 –29 TARC, eosinophil count, WCSC on the upper arm, phosphorus, calcium-phosphorus product and BNP were included as candidate independent variables.…”

“…5,13,27,28 Therefore, among potential predictors that have been previously reported to be associated with CKD-aP in patients undergoing HD or PD (age, sex, diabetes mellitus (DM), dialysis vintage, WCSC, renal Kt/V, peritoneal Kt/V, total Kt/V, urine output, creatinine, urea nitrogen, Hb, ferritin, calcium, phosphorus, calcium-phosphorus product, β 2 microglobulin, α 1 microglobulin, C-reactive protein and BNP), variables with p < 0.2 in univariate linear regression analysis of VAS scores were also included. 1,3 –8,10 –13,27 –29 TARC, eosinophil count, WCSC on the upper arm, phosphorus, calcium-phosphorus product and BNP were included as candidate independent variables. However, because a strong correlation between phosphorus and calcium-phosphorus product was observed, the calcium-phosphorus product was consequently excluded as an independent variable, given the multicollinearity.…”