Epidemiology of Chronic Kidney Diseases (CKD) in Malaysia and Pakistan, Pathophysiology of CKD-Associated Pruritus and Other CKD-Associated Dermatological Disorders (original) (raw)
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Prevalence and severity of pruritus amongst patients with chronic kidney disease
IP Indian Journal of Clinical and Experimental Dermatology, 2020
Introduction: Skin problems are common and diverse in patients with chronic kidney disease (CKD). Pruritus is a highly prevalent condition in patients with chronic kidney disease. It is associated with poor sleep quality, anxiety and depression which may contribute to reduction in quality of life. Objective: To study the prevalence and severity of pruritus among patients with chronic kidney disease. Materials and Methods: An observational study was conducted in 77 consecutive chronic kidney disease patients receiving maintenance hemodialysis for more than 3 months at Manik hospital, Aurangabad, Maharashtra, India were studied during January 2015 to December 2015. Results: Out of 77 patients, 51 (66.23%) of males and 26 (23.67%) of females were examined. The mean age was 51.17 years. Xerosis was the commonest manifestation (87.01%), followed by pruritus (57.14%). Mild pruritus was reported in 59.09% patients whereas severe pruritus was noted in 22.27% patients. High urea, phosphate and ALP levels were noted in severe pruritus group, but difference not statistically significant. 32 patients with pruritus on maintenance HD were followed over next 6 months. Out of 32 patients followed, 37.5% had no change in pruritus. Pruritus improved in 28.12%, while it actually worsened in 34.37% patients. Conclusion: In this study, 57.14% of patients with chronic kidney disease experience pruritus. Gender, age, presence of DM, duration of dialysis was not statistically significant between pruritus and non-pruritus group. Also hematocrit was similar in pruritus and non-pruritus groups. There was no significant difference in calcium, phosphorus and alkaline phosphatase levels in pruritus and non-pruritus groups.
Therapeutic Apheresis and Dialysis, 2019
CKD-associated pruritus is one of the common symptoms in patients undergoing dialysis, thus contributing to the diminished and compromised quality of life. This study aimed to explore the association between the CKD-associated pruritus on quality of life of patients undergoing hemodialysis in Malaysia. A cross-sectional multicenter study, carried out from February to September 2017 at tertiary care settings in Kuala Lumpur, Malaysia. Patients aged 18 years and above, undergoing hemodialysis, understanding Malay language and willing to participate were included. The CKD-associated pruritus was assessed by using Malay 5D-itch scale and Malay FANLTC questionaiare. To determine the factors associated with pruritus and quality of life, multivariate logistic regression analysis was used having P value < 0.05 as statistically significant. Among n = 334 recruited patients with a response rate of 100%, 59.6% were males and total of 61.3% were having CKD-associated pruritus.
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.
Pakistan Journal of Medical and Health Sciences, 2022
Due to injured kidneys, CKD is defined as a glomerular filtration rate of less than 60ml/min/1.73m2 for more than 3 months. The lethal stage of chronic CKDs is the last stage of renal disease, and its frequency has increased over the previous 30 years. Pruritus caused by chronic renal disease is an unpleasant illness that causes itching and reduces sleep quality. The goal of this study is to look at the characteristics of pruritus in people with CKD and how they relate with sleep quality among patients on maintenance hemodialysis.
Journal of Kathmandu Medical College
Background: Uremic pruritus is a common and troublesome symptom of chronic kidney disease. It is one of the dominant dermatological manifestations of chronic kidney disease which affects the quality of life of patients.Objective: To assess the prevalence and severity of uremic pruritus in chronic kidney disease patients undergoing maintenance hemodialysis.Methodology: A prospective cross-sectional study was done over three months among chronic kidney patients undergoing maintenance hemodialysis to show the association of mineral bone disorders with uremic pruritus. Patients complaining of pruritus were taken as cases and then pruritus was quantified using a Visual Analogue Scale.Results: 144 patients participated in this study, out of which 41 (28.47%) were females. Mean age was 54.97±9.75 years and 68.06% patients were on dialysis. Uremic pruritus was seen in 80 patients (55.56%), amongst them 23 patients (28.75 %) had severe pruritus as measured by Visual Analogue Scale. Uremic pr...
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.
Effect of residual kidney function and dialysis adequacy on chronic pruritus in dialysis patients
Nephrology Dialysis Transplantation, 2022
What is already known about this subject? • Chronic kidney disease-associated pruritus (itching) is highly prevalent among dialysis patients and associated with poor sleep, depression, interference with people's work, overall lower quality of life and increased risk of death. • Little is known about factors associated with the severity of pruritus in dialysis patients due to the lack of longitudinal follow-up studies. • Although several hypotheses have been proposed, the etiology and pathophysiology of pruritus in dialysis patients are not fully understood. What this study adds? • The prevalence of pruritus in this cohort of chronic dialysis patients was 70%, of whom 20% experienced severe/extreme burden to pruritus. • Higher residual kidney function and lower levels of serum phosphate were associated with a decreased risk of pruritus in both hemodialysis and peritoneal dialysis patients at 12 months after start of dialysis. • No association was observed between dialysis dose and pruritus in either hemodialysis or peritoneal dialysis patients. What impact this may have on practice or policy? • These insights may help us better understand pruritus and underscore the need for recognition of pruritus in chronic dialysis patients. • These study findings may inform future guidelines about prevention and treatment of pruritus, and emphasizes the importance of residual kidney function in chronic dialysis patients.
Birat Journal of Health Sciences, 2020
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 p...
Ethiopian Journal of Health Sciences, 2016
BACKGROUND: Pruritus is a common cutaneous manifestation of chronic kidney disease (CKD). It is associated with poor sleep quality, anxiety and depression which may contribute to reduction in quality of life (QoL). Paying more attention to pruritus in CKD patients may improve their QoL, reduce kidney disease burden and mortality. This study determined the prevalence, pattern and association of pruritus with QoL in CKD patients. MATERIALS AND METHODS: This was a cross-sectional descriptive study carried out in a Kidney Care Centre, Ondo City, Southwest Nigeria. The severity and intensity of pruritus and health-related QoL were assessed using validated instruments. P-value of < 0.05 was taken as significant. RESULTS: There were 91 CKD subjects with a male:female ratio of 2.1:1. Sixty-nine (75.8%) of the CKD patients were not on dialysis while the remaining twenty-two (24.2%) were on maintenance hemodialysis (MHD). Thirty-nine (42.9%) of the CKD subjects had pruritus which was mild in 25(64.1%), moderate in 8(20.5%) and severe in 6(15.4%). Pruritus was more common in MHD patients compared to predialysis CKD patients(50%vs40.6%) p = 0.47. The median pruritus intensity score was also higher in MHD patients compared to predialysis CKD patients (40vs30) p = 0.51. There was no significant association between gender, age, aetiology of CKD, stage of CKD and pruritus. There was a significant correlation between QoL score and pruritus intensity. (p = < 0.001, r = 0.56). CONCLUSION: Pruritus was common among our CKD subjects and it was not significantly associated with age, gender, stage or etiology of CKD. There was a significant association between impaired QoL and pruritus intensity.