Clinical interpretation of the Uremic Pruritus in Dialysis Patients (UP-Dial) scale: a novel instrument for the assessment of uremic pruritus (original) (raw)
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A Longitudinal Study of Uremic Pruritus in Hemodialysis Patients
Clinical Journal of the American Society of Nephrology, 2010
Background and objectives: Although uremic pruritus (UP) is a highly prevalent complication of chronic kidney disease, it remains poorly characterized. There have been no longitudinal studies of natural history, and no health-related quality of life (HR-QOL) instruments have been developed for UP. The objectives of this study were to describe the natural history of UP, to compare rating scales of itching intensity, and to assess usefulness and validity of HR-QOL instruments for UP.
Academia Journal of Medicine, 2019
Background: Renal pruritus is one of the most debilitating symptom of chronic kidney disease especially affecting patients on maintenance hemodialysis. Subjects and Methods: It was a cross-sectional questionnaire based study. Demographic, dialysis related and biochemical parameters of maintenance hemodialysis patients were recorded, and a pre-defined questionnaire was put to them. Severity was calculated with 12 point pruritus severity scale (PSS), health-related quality of life with SKINDEX-10, and sleep survey with ITCH-MOS. Results: The total of 164 patients (mean age 52 ± 17years, males-57.9%, females-42.1%) completing questionnaire and laboratory analysis were included in the study. Prevalence of pruritus was 53.7% (mild in 31.8%, moderate-45.5%, severe-22.7%). Prevalence was higher in diabetic CKD (p=0.0001), and irregularly dialyzed patients (p=0001). The severity of pruritus correlated with older age (p=0.004), shorter dialysis vintage (p=0.000), irregular dialysis (0.000), higher serum phosphorus (0.003), and parathyroid hormone level (0.000) and higher calcium-phosphorus product (0.001). SKINDEX-10 showed worsening symptoms, emotional and functional quality of life (p=0.000), and poorer sleep quality and quantity as per ITCH-MOS (0.000), with increasing severity of itching. Conclusion: Renal itch is highly prevalent in maintenance hemodialysis patients, most severely affecting diabetics, elderly, irregularly dialyzed patients, with poorly controlled mineral bone parameters. The severity correlates with worsening sleep and overall quality-of-life.
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.
Pars of Jahrom University of Medical Sciences, 2013
Thi study aimed to determine the status of pruritus and its relation to dialysis adequacy and laboratory factors among hemodialysis patients in Shiraz dialysis centers so that appropriate interventions could be planned for promotion of the life quality. Materials and Methods: This is a cross-sectional study on the data collected from 141 patients selected by convenient sampling. We used a questionnaire, interview, and lab test for data collection. Data were analyzed using SPSS 11.5 software and appropriate tests. A p value=0.05 was considered as the significance level. Results: The mean age of our patients was 53±16 years, (82.3% were married), and 53.2% of them were male. Of these patients, 39.7% had pruritus and most of them (48.1%) reported they had pruritus in different times of the day. A significant correlation was found between dialysis adequacy and pruritus (p=0.029), and the correlation of pruritus and high sensitive-C-reactive protein (hs-CRP) was significantly positive (p=0.009). Conclusion: Pruritus is a common problem in haemodialysis patients and is significantly associated with dialysis adequacy and hs-CRP. The level of their quality of life could be enhanced by appropriate interventions.
An epidemiology study of patients with uremic pruritus
Journal of the European Academy of Dermatology and Venereology, 2006
Background Pruritus is a common problem in continuous ambulatory peritoneal dialysis (CAPD) and haemodialysis patients. There are few studies on the clinical characteristics of uremic itch, the cause of which is still unknown. Objectives The aim of this study was to define the prevalence and clinical characteristics of pruritus in CAPD and haemodialysis patients. Methods A questionnaire was used to evaluate pruritus in 52 CAPD and 289 haemodialysis patients in two dialysis units. The relationship of various factors and medical parameters to itch was examined. Results Of the 341 patients, 177 (51.9%) had pruritus at the time of examination, 97 (28.4%) had pruritus in the past. Pruritus was present in 145 (50.2%) of the haemodialysis patients and 32 (61.5%) of the CAPD patients. Men, patients with liver disease, and patients with pruritus before starting dialysis treatment were more likely to have uremic pruritus. Conclusions This study showed us that uremic pruritus was observed more in men than women. The high prevalence of uremic pruritus in our study does not support the decrease of pruritus due to an improvement in the management of dialysis patients.
Jurnal Aisyah : Jurnal Ilmu Kesehatan
Chronic Kidney Disease (CKD) is characterized by progressive loss of kidney function over time due to kidney damage or reduced glomerular filtration rate (GFR) <60 mL/min/173m 2 for >3 months. The increased levels of urea in patients with chronic kidney failure can cause pruritus known as uremic pruritus or chronic kidney disease associated pruritus (CKD-ap). The research method that will be used is PRISMA. These scoping reviews will use a systematic approach and selection process. Library sources were traced from the Proquest, PubMed, Scopus and Google Scholar databases. This scoping review examines the associated factors with pruritus in patients undergoing dialysis. Factors related to uremic pruritus, namely based on analysis through scoping reviews that have been carried out on 8 articles, it was found that the most widely used study design was cross-sectional, the most widely used type of dealisis is hemodialysis with the number of articles is 3 articles and the number of patients that is male 505 samples (60.4%) and women 331 samples (39.6%) with the Total is 836 samples. Factors associated with uremic pruritus are gender, age, dialysis dose, duration of dialysis, urea/urea, C-Reactive Protein (CRP), and parathyroid hormone (PTH).The conclusion is that the factor that most dominant factor affecting pruritus is the factor of laboratory results, which is a factor that can be modified Keyword: Chronic Kidney Disease Dialysis Itching Uremic Patients Causes Pruritus This open access article is under the CC-BY-SA license.