Uremic Pruritus and associated factors in Chronic Dialysis Patients: An Observational Study in Western Nepal

Abstract

Introduction: Pruritus is one of the well-recognized major skin derangements in patients with advanced renal failure and are usually without visible skin lesions. Only few studies have addressed this issue in Nepalese population.
 Objective:.The present study aims to identify the prevalence and associated factors of uremic pruritus in chronic dialysis patients in western Nepal.
 Methodology:A prospective observational study was conducted to include all chronic dialysis patients with uremic pruritus at the Manipal Teaching Hospital, Pokhara, Nepal over a period of one year (June 2018 and May 2019).
 Results: During the study period, a total of 59 patients were included in the study with mean age of 55.8±15.8years,of which 37 (63%) patients developed uremic pruritus.
 Statistically significant relationship betweenpresence of pruritus and pruritus severity with frequency of itching grade and sleep disturbance score among elderly (p=0.001) were observed
 The serum urea can predict uremic pruritus among elderly patients with a good diagnostic value. The multivariate analysis showed male gender, hypertension, elevated serum albumin and random blood sugarwere independent predictors of pruritus in patients undergoing chronic dialysis.
 Conclusions: Our findings demonstrate that higher proportion ofpatients undergoing chronic dialysis werediagnosed with uremic pruritus (63%) and occurrence of pruritus had association with frequency of itching grade and sleep disturbance score .The serum levels of urea may predict the occurrence of pruritus among elderly patients.Furthermore, a large multicenter study is warranted with longer follow up which may provide robust information on the burden of pruritus and its associated factors to guide appropriate management among elderly.

Pruritus and long-term hemodialysis among patients with chronic renal failure

“…Based on the results of research conducted by Kumar [11], who identified the relationship between male sex and pruritus in chronic kidney disease, an international study on pruritis in hemodialysis patients showed men were 1.1 times more likely to experience pruritus. Unlike the study conducted by Hu [8], it is said that there were no significant differences in age found between patients with pruritus and patients without itching, though they were significant.…”

“…Itching can cause delayed sleep and occasionally cause patients to wake up at night [19], [20]. According to Kumar's research [11], blood urea had good diagnostic values for predicting uremic-related pruritus in older people. In patients on chronic dialysis, having a man in the room, having high blood pressure, and having more serum albumin and blood sugar are all independent predictors of pruritus.…”

The effect of lavender aromatherapy and deep breathing exercise on anxietas level in hemodialysis patients

“…The effect of lavender aromatherapy and deep breathing exercise on … (Dwi Retnaningsih) 1403 hypertension, equilibrium syndrome, cramps, nausea, vomiting, headaches, chest discomfort, arrhythmias, itching [5], [6], fever responses, and hypoxemia [7]. Hemodialysis, which takes 12 to 15 hours of treatment time each week, is a lifelong requirement for patients with chronic renal failure.…”