The relationship between uraemic pruritus and quality of life scores in hemodialysis patients

Abstract

Background and Design: Preliminary findings indicate that the adverse effects of hemodialysis (HD) impair mental, physical and social wellbeing as well as the renal disease itself. Little is known about the influence of uraemic pruritus on HD patients' well-being. We aimed to assess the association of pruritus with dermatology-specific health-related quality of life and general quality of life in HD patients. Materials and Methods: Forty-five patients with chronic renal failure, over 18 years of age, on regular HD therapy at the nephrology department were enrolled into the study. Detailed dermatological examination was performed. Sociodemographic and clinical data form, The World Health Organization Quality of Life-BREF (WHOQOL-BREF-TR) and Dermatology Life Quality Index (DLQI) were administered to all patients. Results: The patients were divided into two study groups as patients with pruritus (n=27, 60%) and without pruritus (n=18, 40%). DLQI scores of patients with pruritus were significantly higher than that of those without pruritus (p<0.05). The scores in physical and environmental domains of WHOQOL-BREF-TR in patients with pruritus were significantly lower than that in those without pruritus (p<0.05). There was no significant difference between the two groups in terms of scores in psychological and social domains (p>0.05). There was a positive correlation of the duration of the disease with scores in psychological, social and environmental domains of WHOQOL-BREF-TR (p<0.05). Conclusion: Uraemic pruritus in HD patients adversely affects their dermatology-specific health-related quality of life and general quality of life in various ways. Dermatologists should be aware of this negative impact and establish treatment options for relieving HD patients.

Quality of Life in Dialysis Treatment Options

“…Due to ESRD, uremic toxins cannot be eliminated from the body and uremic pruritus is frequently observed especially in HD patients (Kücükünal et al, 2015). Studies have reported that uremic pruritus with itching and dry skin is frequently observed in 40-90% of ESRD (Ramakrishnan et al, 2013).…”

Effects of Uremic Pruritus on Dermatological and Kidney Disease Quality of Life in Patients Receiving Hemodialysis

“…Uremic pruritus can cause physical, psychosocial, and emotional deterioration in general health perceptions of patients (1,6). Uremic pruritus generally reduces the dermatological quality of life of HD patients due to the continuous sense of itching and lesions and dryness occurring due to itching (10). Uremic pruritus causes sleeplessness, fatigue/exhaustion, anger, anxiety, depression as well as decreased self-esteem, social isolation, a decline in self-care and quality of life, along with the scratching behavior during the day and especially at night, making the disease management more difficult (4)(5)(6)(7)(8)(11)(12)(13).…”

“…Due to these itching-related problems, patients have a 17% higher mortality rate, along with pruritus and sleep problems, than regular HD patients (14). In a study conducted on HD patients, it was indicated that the dermatological quality of life of patients with uremic pruritus was low (4,10,15).…”

Üremik Pruritus ve Hemşirelik Yönetimi

“…Küçükünal ve ark. 'nın [13] çalışmalarında diyalize giren hastaların %60'nda ÜP görüldüğünü ve bu hastaların dermatolojik yaşam kalitesinin düşük olduğunu bildirmiştir. Üremik pruritusta kaşıntıyı gidermeye yönelik semptomatik tedavi uygulanmaktadır [12].…”