Affiliation:
1. Department of Internal Medicine IV – Nephrology and Hypertension, Medical University Innsbruck , Innsbruck , Austria
2. Austrian Dialysis and Transplant Registry, Medical University Innsbruck , Innsbruck , Austria
Abstract
ABSTRACT
Background
Chronic kidney disease–associated pruritus (CKD-aP) is an underrated symptom in patients with impaired kidney function. The present study assessed the prevalence, impact on quality of life (QoL) and risk factors for CKD-aP in a contemporary national cohort of patients on haemodialysis. In addition, we evaluated attending physicians’ awareness and approach to therapy.
Methods
Validated patient's and physician's questionnaires on pruritus severity and QoL were used in combination with information obtained by the Austrian Dialysis and Transplant Registry.
Results
The prevalence of mild, moderate and severe pruritus in 962 observed patients was 34.4%, 11.4% and 4.3%. Physicians’ estimated prevalence values were 25.0 (95% CI 16.8–33.2), 14.4 (11.3–17.6) and 6.3% (4.9–8.3), respectively. The estimated national prevalence estimate extrapolated from the observed patients was 45.0% (95% CI 39.5–51.2) for any, 13.9% (95% CI 10.6–17.2) for moderate and 4.2% (95% CI 2.1–6.2) for severe CKD-aP. CKD-aP severity was significantly associated with impaired QoL. Risk factors for moderate–severe pruritus were higher C-reactive protein [odds ratio (OR) 1.61 (95% CI 1.07–2.43)] and parathyroid hormone (PTH) values [OR 1.50 (95% CI 1.00–2.27)]. Therapy for CKD-aP included changes in the dialysis regimen, topical treatments, antihistamines, gabapentin and pregabalin and phototherapy in a majority of centres.
Conclusions
While the overall prevalence of CKD-aP in our study is similar to that in previously published literature, the prevalence of moderate–severe pruritus is lower. CKD-aP was associated with reduced QoL and elevated markers of inflammation and PTH. The high awareness of CKD-aP in Austrian nephrologists may explain the lower prevalence of more severe pruritus.
Funder
CSL Behring
Vifor Pharma
Austrian Society of Nephrology
Publisher
Oxford University Press (OUP)
Subject
Transplantation,Nephrology
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献