Prevalence of Uremic Pruritus, Its Risk Factors and Impact on Health-Related Quality-Of-Life in Patients on Maintenance Hemodialysis

Prevalence of Uremic Pruritus, Its Risk Factors and Impact on Health-Related Quality-Of-Life

  • Simran Kaur Assistant Professor Nephrology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
  • Deepak Sharma Consultant Nephrologist, Sri Mata Vaishno Devi NarayanaSuperspeciality Hospital, Katra, Jammu and Kashmir, India
  • Suman Sethi Assistant Professor Nephrology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
  • Preet Mohinder Singh Sohal Assistant Professor Nephrology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
  • Harmandeep Singh Chahal Associate Professor Urology and Renal Transplant, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
  • Vikas Makkar Professor and Head Nephrology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
Keywords: Uremia, uremic/renal pruritus, maintenance hemodialysis, health-related quality of life, sleep

Abstract

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.

Published
2019-12-30