Prevalence and characterization of uremic pruritus in patients undergoing hemodialysis: uremic pruritus is still a major problem for patients with end-stage renal disease (original) (raw)

Risk Factors Of Uremic Pruritus In Hemodialysis Patients :Narrative Literature Review

Uremic pruritus is a dermatological manifestation that common and disturbing problem in patients undergoing hemodialysis with an incidence of 20%-90%. The pathogenesis of uremic pruritus is complex and incompletely understood. This review study aimed to identify factors of uremic pruritus in hemodialysis patients.A literature review searched three database (Proquest, NCBI, and Google Scholar) for previous studies using cross sectional, case control, and descriptive kuantitative desaign published between 2015-2020. The PRISMA checklist guided by year, title, abstract, and full text. The JBI Critical Appraisal Tools are used to assessing the quality of articles. A total ofthirteen articles which met inclusion criteria in this study.Each article identified a different risk factor for uremic pruritus with at least one risk factor identified by the two articles. The majority of study designs were cross-sectional with eleven articles. The average number of participants were more than fifty. A total of five risk factors that contributing of uremic pruritus: 1) clinical features (increased urea, creatinin, hemoglobin, protein C reactif, Interleukin (IL)-2 dan Interleukin (IL)-6), 2) dialysis adequacy, 3) duration of hemodialysis, 4) gender, and 5)age. Increased of urea level were indicated as the most dominant risk factor because it acts as an intermediary for others.

Moderate-to-severe pruritus in untreated or non-responsive hemodialysis patients: results of the French prospective multicenter observational study Pruripreva

Clinical Kidney Journal

Background Chronic kidney disease-associated pruritus (CKD-aP) is a common condition in patients treated with hemodialysis, and has a negative impact on quality of life (QoL). Due to the lack of standardized diagnostic tools and frequent underreporting, pruritus prevalence remains poorly documented. Methods Pruripreva was a prospective multicenter observational study that aimed to evaluate the prevalence of moderate to severe pruritus in a cohort of French hemodialysis patients. The primary endpoint was the rate of patients with mean Worst Itch Numerical Rating Scale (WI-NRS) score ≥4 calculated over 7 days (moderate pruritus, 4–6; severe, 7–8; very severe, 9–10). Impact of CKD-aP on QoL was analyzed according to its severity (WI-NRS), using 5-D Itch scale, EQ-5D and Short Form (SF)-12. Results Mean WI-NRS was ≥4 in 306 patients (mean age, 66.6 years; male, 57.6%) out of 1304 and prevalence of moderate to very severe pruritus was 23.5% (95% confidence interval 21.2–25.9). Pruritus w...

Pruritus in hemodialysis patients: The problem remains

Hemodialysis International, 2009

Pruritus is still one of the most common and disturbing symptoms of end-stage renal disease. The objective of this study is to analyze the prevalence of pruritus in hemodialysis patients and the possible factors implicated in its genesis. In a cross-sectional study, 101 patients on hemodialysis at our center were screened for pruritus. The relationship of various factors with pruritus was evaluated. Of the 101 patients included, 31(30.7%) had pruritus at the time of examination. Patients with pruritus were significantly older than those without pruritus (P=0.0027). Pruritus tended to be more prevalent in patients undergoing dialysis 3 times a week than in those undergoing daily dialysis, but the difference did not reach statistical significance (P=0.0854). Lower transferrin saturation levels were found in patients with pruritus than in those without pruritus (P=0.0144). C-reactive protein levels were significantly higher in patients with pruritus than in those without pruritus (P=0.0013). There was no significant difference between the groups in the levels of the other inflammatory biomarkers measured. However, there was a tendency toward a correlation between the levels of α-1-glycoprotein and the intensity of pruritus (P=0.0834). Our results suggest a possible relationship of the inflammatory response upregulation to pruritus. Additionally, there was a positive relationship between pruritus and iron deficiency, possibly associated with inflammatory elevation of hepcidin. A better understanding of the factors implicated in the genesis of pruritus related to end-stage renal disease is crucial in the development of more effective treatments for this symptom.