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

Abstract

Background: Thymus and activation-regulated chemokine (TARC), which induces a Th2-dominated inflammation, is a well-known biomarker that reflects the severity of atopic dermatitis. The present study aimed to evaluate TARC as a Th2-associated marker with chronic kidney disease-associated pruritus (CKD-aP) in patients with peritoneal dialysis (PD). Methods: This single-centre cross-sectional study included patients who underwent PD in our hospital between August 2020 and July 2021. The severity and impaired quality of life (QOL) of CKD-aP were assessed using the visual analogue scale (VAS) and Japanese version of the 5-D itch scale (5D-J), respectively. Results: A total of 48 patients with PD were included in the present study. Age and dialysis vintage were (mean ± SD) 64.8 ± 12.0 year and (median (IQR)) 38.5 (11.5–91.5) month, respectively. VAS and 5D-J scores were 3.3 ± 2.0 and 10.5 (9.0–12.0), respectively. Serum TARC level was 481.5 (278.9–603.4) pg/mL (upper limits of normal 450 pg/mL) and significantly correlated with VAS ( r = 0.39, p = 0.006) and 5D-J score ( r = 0.37, p = 0.009). Multivariate linear analysis revealed that higher serum TARC level was significantly associated with VAS ( p < 0.001) and 5D-J score ( p < 0.001). Furthermore, the serum brain natriuretic peptide level tended to be associated with VAS ( p = 0.060) and 5D-J score ( p = 0.029). Conclusion: Serum TARC level is an independent predictor of the severity and impaired QOL of CKD-aP in patients with PD, and TARC might be involved in the pathogenesis of CKD-aP.

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“…Lebherz‐Eichinger et al investigated serum and urine chemokine levels in patients with CKD and reported that serum CCL17 level was 359 pg/mL (median) in patients with CKD stage 5 [34]. In a recent study evaluating the association between serum CCL17 and the severity of CKD‐associated pruritus, serum CCL17 level was 481.5 pg/mL (median) in peritoneal dialysis patients [35]. However, there were no reports on CCL17 levels in HD patients.…”