A Study of the Prevalence of Pruritus in Hemodialysis Patients and its Relationship with Laboratory Indicators and Dialysis Characteristics
| International Journal of Medical Science |
| © 2023 by SSRG - IJMS Journal |
| Volume 10 Issue 5 |
| Year of Publication : 2023 |
| Authors : Haya Radwan, Ibrahim Sulaiman, Abdulfattah Abbas |
10.14445/23939117/IJMS-V10I5P106
How to Cite?
Haya Radwan, Ibrahim Sulaiman, Abdulfattah Abbas, "A Study of the Prevalence of Pruritus in Hemodialysis Patients and its Relationship with Laboratory Indicators and Dialysis Characteristics," SSRG International Journal of Medical Science, vol. 10, no. 5, pp. 38-45, 2023. Crossref, https://doi.org/10.14445/23939117/IJMS-V10I5P106
Abstract:
Pruritus is a common and frustrating problem in hemodialysis patients, causing discomfort and skin damage. Pathogenesis is still unknown, and it is thought to be multifactorial. The main goal of this study is to know the prevalence of pruritus in hemodialysis patients. 200 hemodialysis patients were included in this study. Data were collected using the Visual Analog Scale (VAS) questionnaire. We investigated whether the duration of hemodialysis, type of dialysate, Kt/V, and laboratory indicators such as phosphorous, calcium, magnesium, and blood urea were correlated to pruritus. Pruritus was found in 72.5% of the hemodialysis patients. 58% of the research samples studied were males, and 42% were females. There were no statistically significant differences between genders, the diseases leading to chronic kidney and the severity of itching. There are statistically significant differences between age groups, calcium and vitamin D intake, the type of hemodialysis device, the years of dialysis treatment, the type of anticoagulant, Kt/V, and the increase in the severity of itching( P<0.005). Pruritus remains an important and frustrating problem in dialysis patients. High levels of phosphorous, calcium, and urea contribute to itching.
Keywords:
CKD, Hemodialysis, Pruritus, Itching, Uremic.
References:
[1] Theodor W. Post, and Burton D. Rose, “Overview of the Management of Chronic Kidney Disease in Adults,” Up to Date, 2007.
[Google Scholar]
[2] Mario Bonomini et al., “New Treatment Approaches for the Anemia of CKD,” American Journal of Kidney Diseases, vol. 67, no. 1, pp. 133-142, 2016.
[CrossRef] [Google Scholar] [Publisher Link]
[3] Lesley A. Stevens et al., “Assessing Kidney Function-Measured and Estimated Glomerular Filtration Rate,” New England Journal of Medicine, vol. 354, pp. 2473-2483, 2006.
[CrossRef] [Google Scholar] [Publisher Link]
[4] Jonathan Himmelfarb, and T. Alp Ikizler, “Hemodialysis,” New England Journal of Medicine, vol. 363, pp. 1833-1845, 2010.
[CrossRef] [Google Scholar] [Publisher Link]
[5] Sidney M. Kobrin, “Uremic Pruritus,” Up to Date, 2017.
[Google Scholar] [Publisher Link]
[6] Nurten Ozen et al., “Uremic Pruritus and Associated Factors in Hemodialysis Patients: A Multi-Center Study,” Kidney Research and Clinical Practice, vol. 37, no. 2, pp. 138-147, 2018.
[CrossRef] [Google Scholar] [Publisher Link]
[7] Tejesh S. Patel, Barry I. Freedman, and Gil Yosipovitch, “An Update on Pruritus Associated with CKD,” American Journal of Kidney Diseases, vol. 50, no. 1, pp. 11-20, 2007.
[CrossRef] [Google Scholar] [Publisher Link]
[8] Murphy, and Carmichael, “Renal Itch,” Clinical and Experimental Dermatology, vol. 25, no. 2, 103-106, 2000.
[CrossRef] [Google Scholar] [Publisher Link]
[9] Jacek C. Szepietowski et al., “Uremic Pruritus: A Clinical Study of Maintenance Hemodialysis Patients,” The Journal of Dermatology, vol. 29, no. 10, pp. 621-627, 2002.
[CrossRef] [Google Scholar] [Publisher Link]
[10] Richard J. Johnson et al., Comprehensive Clinical Nephrology, 9th ed., Elsevier Health Sciences, pp. 1-1312, 2018.
[Google Scholar] [Publisher Link]
[11] Julia R. Nunley et al., “Dermatologic Manifestations of Renal Disease,” Dermatology, 2020.
[Google Scholar] [Publisher Link]
[12] P. Udayakumar et al., “Cutaneous Manifestations in Patients with Chronic Renal Failure on Hemodialysis,” Indian Journal of Dermatology, Venereology and Leprology, vol. 72, no. 2, pp. 119-125, 2006.
[CrossRef] [Google Scholar] [Publisher Link]
[13] Arshad Jamal, and P.T.Subramanian, “Pruritus among End-Stage Renal Failure Patients on Hemodialysis,” Saudi Journal of Kidney Diseases and Transplantation, vol. 11, no. 2, pp. 181-185, 2000.
[Google Scholar] [Publisher Link]
[14] Sanzida S. Swarna et al., “Pruritus Associated with Chronic Kidney Disease: A Comprehensive Literature Review,” Cureus, vol. 11, no. 7, pp. 1-6, 2019.
[CrossRef] [Google Scholar] [Publisher Link]
[15] Eman Sanad et al., “Prevalence of Cutaneous Manifestations in Chronic Renal Failure Patients on Regular Hemodialysis: A Hospital-Based Study,” Egyptian Journal of Dermatology and Venerology, vol. 34, no. 1, pp. 27‑35, 2014.
[CrossRef] [Google Scholar] [Publisher Link]
[16] Maha M. Sultan et al., “Cutaneous Manifestations in Egyptian Patients with Chronic Renal Failure on Regular Hemodialysis,” Egyptian Women Dermatologic Society, vol. 27, no. 1, pp. 49‑55, 2010.
[Google Scholar] [Publisher Link]
[17] Jacek C. Szepietowski, Adam Reich, and Robert A. Schwartz, “Uremic Xerosis,” Nephrol Dial Transplant, vol. 19, no. 11, 2709‑2712, 2004.
[CrossRef] [Google Scholar] [Publisher Link]
[18] Yung-Chih Chen, Wan-Ting Chiu, and Mai-Szu Wu, “Therapeutic Effect of Topical Gamma-Linolenic Acid on Refractory Uremic Pruritus,” American Journal of Kidney Diseases, vol. 48 no. 1, pp. 69-76, 2006.
[CrossRef] [Google Scholar] [Publisher Link]
[19] Atieh Makhlough et al., “Topical Capsaicin Therapy for Uremic Pruritus in Patients on Hemodialysis,” Iranian Journal of Kidney Diseases, vol. 4, no. 3, pp. 173-140, 2010.
[Google Scholar] [Publisher Link]
[20] Shigeki Inui, “Nalfurafine Hydrochloride to Treat Pruritus: A Review,” Clinical, Cosmetic and Investigational Dermatology, vol. 8, no. 5, pp. 249-255, 2015.
[CrossRef] [Google Scholar] [Publisher Link]
[21] Pentamveli Beegum Sherjeena et al., “A Controlled Trial of Narrowband Ultraviolet B Phototherapy for the Treatment of Uremic Pruritus,” Indian Journal of Dermatology, Venereology, and Leprology, vol. 83, no.2, pp. 247-249, 2017.
[CrossRef] [Google Scholar] [Publisher Link]
[22] M.I. Duque et al., “Uremic Pruritus is Associated with Higher kt/V and Serum Calcium Concentration,” Clinical Nephrology, vol. 66, no. 3, pp. 184-191, 2006.
[CrossRef] [Google Scholar] [Publisher Link]
[23] Seyed Mansour Gatmiri et al., “Uremic Pruritus and Serum Phosphorus Level,” Acta Medica Iranica, vol. 51, no. 7, pp. 477-481, 2013.
[Google Scholar] [Publisher Link]
[24] George Ch. Kosmadakis et al., “Characteristics of Uremic Pruritus in Hemodialysis Patients: Data from a Single Center,” Kidney International, vol. 74, no. 7, pp. 962-973, 2008.
[CrossRef] [Google Scholar] [Publisher Link]
[25] I. Narita et al., “Etiology and Prognostic Significance of Severe Uremic Pruritus in Chronic Hemodialysis Patients,” Kidney International, vol. 69, no. 9, pp. 1626-1632, 2006.
[CrossRef] [Google Scholar] [Publisher Link]
[26] Mei-Ju Ko et al., “Uremic Pruritus, Dialysis Adequacy, and Metabolic Profiles in Hemodialysis Patients: A Prospective 5-Year Cohort Study,” PLOS ONE, vol. 8, no. 8, pp. 1-8, 2013.
[CrossRef] [Google Scholar] [Publisher Link]
[27] Marion Haubitz et al., “Chronic Induction of C-Reactive Protein by Hemodialysis, But Not By Peritoneal Dialysis Therapy,” Peritoneal Dialysis International, vol. 16, no. 2, pp. 158-162, 1996.
[CrossRef] [Google Scholar] [Publisher Link]
[28] Toshimasa Takahashi et al., “Interleukin-6 Gene Expression in Peripheral Blood Mononuclear Cells from Patients Undergoing Hemodialysis or Continuous Ambulatory Peritoneal Dialysis,” Renal Failure, vol. 22, no. 3, pp. 345-354, 2000.
[CrossRef] [Google Scholar] [Publisher Link]
[29] Hon-Yen Wu et al., “A Comparison of Uremic Pruritus in Patients Receiving Peritoneal Dialysis and Hemodialysis,” Medicine, vol. 95, no. 9, pp. 1-6, 2016.
[CrossRef] [Google Scholar] [Publisher Link]
[30] S. Mistik et al., “An Epidemiology Study of Patients with Uremic Pruritus,” Journal of the European Academy of Dermatology and Venereology, vol. 20, no. 6, pp. 672-678, 2006.
[CrossRef] [Google Scholar] [Publisher Link]
[31] Omar Lupi et al., “Cutaneous Manifestations in End Stage Renal Disease,” Anais Brasileiros De Dermatologia, vol. 86, no. 2, pp. 319‑326, 2011.[CrossRef] [Google Scholar] [Publisher Link]