Prevalence of chronic kidney disease-associated pruritus among adult dialysis patients

Hu, Xinmiao; Sang, Yan; Yang, Mei; Chen, Xue; Tang, Wenjuan

doi:10.1097/md.0000000000010633

Cited by 84 publications

(66 citation statements)

References 57 publications

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“…In our study, a longer duration of CKD and hemodialysis had a very negligible effect on pruritus, which differs from another study in which a duration of hemodialysis of more than 2 years resulted in higher rates of pruritus (75% vs 25%) compared to those doing hemodialysis for less than 2 years [38]. The variation in pruritus prevalence reported in different studies may be due differences in study designs, selection of participants (e.g., study populations, races, and sample sizes), and the definition of CKD-aP [39]. In our study it was also revealed that hemodialysis machines were limited, and pressure from too many patients was a contributing factor to inadequate hemodialysis.…”

Section: Discussionmentioning

confidence: 88%

Prevalence of chronic kidney disease-associated pruritus, and association with sleep quality among hemodialysis patients in Pakistan

et al. 2018

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BackgroundThe prevalence of chronic kidney disease-associated pruritus (CKD-aP) varies from 22% to 84% among patients receiving hemodialysis. It occurs more frequently at night, and often affects patient’s sleep quality. CKD-aP is often unreported by patients, and many do not receive effective treatment. There is, however, a paucity of available data on the prevalence and impact of CKD-aP on patients receiving hemodialysis in Pakistan.MethodsA multicenter cross-sectional study was undertaken from July 2016 to April 2017 at a tertiary care hospitals in Pakistan.Results354 patients undergoing hemodialysis were studied. 35.6% had CKD for 1–2 years, and 42.4% were receiving hemodialysis for 1–2 years. The prevalence of pruritus was 74%. The median [interquartile range] score for pruritus was 10.0 (out of possible 25) [8.0–12.0]; while the median [interquartile range] Pittsburgh Sleep Quality Index (PSQI) score was 8.0 (out of possible 21) [7.0–10.0]'. Pruritus was significantly correlated with the sleep score (r = 0.423, p<0.001). The results of the multivariate linear regression revealed a positive association between pruritus and age of patients (β = 0.031; 95% CI = 0.002–0.061; p = 0.038) and duration of CKD (β = -0.013; 95% CI = -0.023 –-0.003; p = 0.014). Similarly there was a positive association between sleep score and duration of CKD (β = 0.010; 95% CI = 0.002–0.019; p = 0.012) and pruritus (β = 0.143; 95% CI = 0.056–0.230; p = 0.001).ConclusionsChronic kidney disease-associated pruritus is very common in patients receiving hemodialysis in Pakistan. Pruritus is significantly associated with poor sleep quality.

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Section: Discussionmentioning

confidence: 88%

Prevalence of chronic kidney disease-associated pruritus, and association with sleep quality among hemodialysis patients in Pakistan

et al. 2018

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“… 26 In a study of 223 patients on PD and 425 HD patients from Korea, the prevalence of at least mild pruritus was 62.5% in HD patients and 48.3% in patients on PD. 24 A meta-analysis of 6 cross-sectional prevalence studies (2 PD-only and 4 mixed HD and PD) showed a prevalence of CKD-aP of 56% (95% CI, 44%–68%) 28 ; however, the severity of this pruritus was not reported.…”

Section: Diagnosismentioning

confidence: 99%

CKD-Associated Pruritus: New Insights Into Diagnosis, Pathogenesis, and Management

Verduzco

Shirazian

2020

Kidney International Reports

100

113

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Chronic kidney disease-associated pruritus (CKD-aP) is a common, troubling and in some cases debilitating problem for patients with CKD and end-stage renal disease. Despite a prevalence rate of approximately 20% in CKD and 40% in end-stage renal disease, and a clear association with poorer psychosocial and medical outcomes, this condition is often underreported by patients and overlooked by health care providers. This is likely due, in part, to uncertainty regarding its pathogenesis and treatment. Most commonly, CKD-aP is attributed to toxin build-up, peripheral neuropathy, immune system dysregulation, or opioid dysregulation. Prior treatment studies of CKD-aP have targeted these potential etiologies but have been limited by noncontrolled design, small sample size, and non-uniform definitions of CKD-aP. Recently, several large, randomized controlled trials targeting opioid dysregulation have yielded promising results. These trials have spurred new hope for understanding and treating this condition.

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“…Uremic pruritus is a common complication in patients with end-stage kidney disease. 1 The discomfort caused by pruritus can cause sleep disturbance, 2,3 depression, 3,4 and lack of concentration. 2 In hemodialysis patients, moderate and severe uremic pruritus is associated with higher mortality risk.…”

Section: Introductionmentioning

confidence: 99%

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

Minato

Hirai

Morino

et al. 2020

IJNRD

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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.

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Prevalence of chronic kidney disease-associated pruritus among adult dialysis patients

Cited by 84 publications

References 57 publications

Prevalence of chronic kidney disease-associated pruritus, and association with sleep quality among hemodialysis patients in Pakistan

Prevalence of chronic kidney disease-associated pruritus, and association with sleep quality among hemodialysis patients in Pakistan

CKD-Associated Pruritus: New Insights Into Diagnosis, Pathogenesis, and Management

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

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