Itching in dialysis patients: impact on health-related quality of life and interactions with sleep problems and psychological symptoms—results from the RENINE/PROMs registry

Author:

van der Willik Esmee M1ORCID,Lengton Robin1ORCID,Hemmelder Marc H2,Hoogeveen Ellen K134,Bart Hans A J5,van Ittersum Frans J6,ten Dam Marc A G J78,Bos Willem Jan W39,Dekker Friedo W1,Meuleman Yvette1ORCID

Affiliation:

1. Department of Clinical Epidemiology, Leiden University Medical Center , Leiden, The Netherlands

2. Department of Internal Medicine, Maastricht University Medical Center and CARIM School for Cardiovascular Diseases, Maastricht University , Maastricht, The Netherlands

3. Department of Nephrology, Leiden University Medical Center , Leiden, The Netherlands

4. Department of Nephrology, Jeroen Bosch Hospital , Den Bosch, The Netherlands

5. Dutch Kidney Patients Association , Bussum, The Netherlands

6. Department of Nephrology, Amsterdam University Medical Center , Amsterdam, The Netherlands

7. Nefrovisie Foundation , Utrecht, The Netherlands

8. Department of Internal Medicine, Canisius Wilhelmina Hospital , Nijmegen, The Netherlands

9. Department of Internal Medicine, St Antonius Hospital , Nieuwegein, The Netherlands

Abstract

ABSTRACT Background Itching (pruritus) is common in dialysis patients, but little is known about its impact on health-related quality of life (HRQOL), sleep problems and psychological symptoms. This study investigates the impact of itching in dialysis patients by looking into the persistence of itching, the effect of itching on the course of HRQOL and the combined effect of itching with sleep problems and with psychological symptoms on HRQOL. Methods Data were obtained from the RENINE/PROMs registry and included 2978 dialysis patients who completed patient-reported outcome measures between 2018 and 2020. Itching, sleep problems and psychological symptoms were assessed with the Dialysis Symptom Index (DSI) and HRQOL with the 12-item Short Form Health Survey. Effects of itching on HRQOL and interactions with sleep problems and psychological symptoms were investigated cross-sectionally and longitudinally using linear regression and linear mixed models. Results Half of the patients experienced itching and in 70% of them, itching was persistent. Itching was associated with a lower physical and mental HRQOL {−3.35 [95% confidence interval (CI) −4.12 to −2.59) and −3.79 [95% CI −4.56 to −3.03]}. HRQOL remained stable during 2 years and trajectories did not differ between patients with or without itching. Sleep problems (70% versus 52%) and psychological symptoms (36% versus 19%) were more common in patients with itching. These symptoms had an additional negative effect on HRQOL but did not interact with itching. Conclusions The persistence of itching, its impact on HRQOL over time and the additional effect on HRQOL of sleep problems and psychological symptoms emphasize the need for recognition and effective treatment of itching to reduce symptom burden and improve HRQOL.

Funder

Nierstichting

Patiëntenfederatie

Vifor Pharma

Zorgverzekeraars

Publisher

Oxford University Press (OUP)

Subject

Transplantation,Nephrology

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