Chronic Kidney Disease-Associated Pruritus in Patients Undergoing Haemodialysis—A Cross-Sectional Study

<i>Background and Objectives</i>: Chronic kidney disease-associated pruritus (CKD-aP) is a burdensome symptom associated with impaired patient-reported outcomes. There is a paucity of research in this area with unclear aetiology, under-reporting of this symptom, and limited treatment opt...

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Main Authors: Teng Wang, Jing-Xin Goh, Wubshet Tesfaye, Kamal Sud, Connie Van, Linda Le Do, Surjit Tarafdar, Ronald L. Castelino
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/6/993
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author Teng Wang
Jing-Xin Goh
Wubshet Tesfaye
Kamal Sud
Connie Van
Linda Le Do
Surjit Tarafdar
Ronald L. Castelino
author_facet Teng Wang
Jing-Xin Goh
Wubshet Tesfaye
Kamal Sud
Connie Van
Linda Le Do
Surjit Tarafdar
Ronald L. Castelino
author_sort Teng Wang
collection DOAJ
description <i>Background and Objectives</i>: Chronic kidney disease-associated pruritus (CKD-aP) is a burdensome symptom associated with impaired patient-reported outcomes. There is a paucity of research in this area with unclear aetiology, under-reporting of this symptom, and limited treatment options and management strategies in clinical settings. The objective of this study was to investigate the prevalence of CKD-aP, patient and dialysis-related factors associated with the occurrence of CKD-aP, and the correlation between CKD-aP severity and quality of life, sleep, anxiety, and depression. <i>Materials and Methods</i>: This cross-sectional study was conducted in 88 adult (≥18 years) patients undergoing haemodialysis at the outpatient dialysis centre at a major Australian tertiary care university teaching hospital. Demographic- and dialysis-related factors were obtained from electronic medical records and/or patients, while patient outcomes were determined from the self-reported questionnaires; 5-D itch scale, EQ-5D-5L, Patient Health Questionnaire-9, and Beck Anxiety Inventory. We compared demographic, patient-, and dialysis-related factors associated with CKD-aP. <i>Results</i>: Out of 88 patients, 67 (76%) agreed to participate in the study. In total, 27 patients (40%) reported having CKD-aP. Most participants experienced moderate CKD-aP severity (<i>n</i> = 12), followed by severe or very severe (<i>n</i> = 9) and mild (<i>n</i> = 6) symptoms. Whilst there was no significant difference in the demographic characteristics, number of medications, dialysis vintage, and Kt/V, a higher number of pruritic participants experienced obstructive sleep apnoea. There was a statistically significant correlation between CKD-aP severity and depression scores (<i>p</i> = 0.009). However, there were no significant correlation between CKD-aP and HRQOL (<i>p</i> = 0.506). The correlations between CKD-aP severity and outcomes such as sleep and anxiety were also not statistically significant, although they were marginally close (<i>p</i> = 0.069 and <i>p</i> = 0.095, respectively). <i>Conclusions</i>: This study reports a substantial prevalence of CKD-aP reported among patients undergoing HD and the association of severe CKD-aP with depression. Despite the limitation of a small sample size from a single dialysis centre, our findings suggest that the severity of CKD-aP may have implications for patient-reported outcomes. This warrants further investigation in larger-scale studies to better understand the association and optimise outcomes.
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spelling doaj-art-fa007606b4e54080af1c3bc17a1cead42025-08-20T03:27:29ZengMDPI AGMedicina1010-660X1648-91442025-05-0161699310.3390/medicina61060993Chronic Kidney Disease-Associated Pruritus in Patients Undergoing Haemodialysis—A Cross-Sectional StudyTeng Wang0Jing-Xin Goh1Wubshet Tesfaye2Kamal Sud3Connie Van4Linda Le Do5Surjit Tarafdar6Ronald L. Castelino7School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, AustraliaSchool of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, AustraliaSchool of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, AustraliaSydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, AustraliaSchool of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, AustraliaSchool of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, AustraliaFaculty of Medicine, Western Sydney University, Sydney, NSW 2751, AustraliaSchool of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia<i>Background and Objectives</i>: Chronic kidney disease-associated pruritus (CKD-aP) is a burdensome symptom associated with impaired patient-reported outcomes. There is a paucity of research in this area with unclear aetiology, under-reporting of this symptom, and limited treatment options and management strategies in clinical settings. The objective of this study was to investigate the prevalence of CKD-aP, patient and dialysis-related factors associated with the occurrence of CKD-aP, and the correlation between CKD-aP severity and quality of life, sleep, anxiety, and depression. <i>Materials and Methods</i>: This cross-sectional study was conducted in 88 adult (≥18 years) patients undergoing haemodialysis at the outpatient dialysis centre at a major Australian tertiary care university teaching hospital. Demographic- and dialysis-related factors were obtained from electronic medical records and/or patients, while patient outcomes were determined from the self-reported questionnaires; 5-D itch scale, EQ-5D-5L, Patient Health Questionnaire-9, and Beck Anxiety Inventory. We compared demographic, patient-, and dialysis-related factors associated with CKD-aP. <i>Results</i>: Out of 88 patients, 67 (76%) agreed to participate in the study. In total, 27 patients (40%) reported having CKD-aP. Most participants experienced moderate CKD-aP severity (<i>n</i> = 12), followed by severe or very severe (<i>n</i> = 9) and mild (<i>n</i> = 6) symptoms. Whilst there was no significant difference in the demographic characteristics, number of medications, dialysis vintage, and Kt/V, a higher number of pruritic participants experienced obstructive sleep apnoea. There was a statistically significant correlation between CKD-aP severity and depression scores (<i>p</i> = 0.009). However, there were no significant correlation between CKD-aP and HRQOL (<i>p</i> = 0.506). The correlations between CKD-aP severity and outcomes such as sleep and anxiety were also not statistically significant, although they were marginally close (<i>p</i> = 0.069 and <i>p</i> = 0.095, respectively). <i>Conclusions</i>: This study reports a substantial prevalence of CKD-aP reported among patients undergoing HD and the association of severe CKD-aP with depression. Despite the limitation of a small sample size from a single dialysis centre, our findings suggest that the severity of CKD-aP may have implications for patient-reported outcomes. This warrants further investigation in larger-scale studies to better understand the association and optimise outcomes.https://www.mdpi.com/1648-9144/61/6/993chronic kidney disease-associated pruritusprevalenceoutcomesfactorsseverity
spellingShingle Teng Wang
Jing-Xin Goh
Wubshet Tesfaye
Kamal Sud
Connie Van
Linda Le Do
Surjit Tarafdar
Ronald L. Castelino
Chronic Kidney Disease-Associated Pruritus in Patients Undergoing Haemodialysis—A Cross-Sectional Study
Medicina
chronic kidney disease-associated pruritus
prevalence
outcomes
factors
severity
title Chronic Kidney Disease-Associated Pruritus in Patients Undergoing Haemodialysis—A Cross-Sectional Study
title_full Chronic Kidney Disease-Associated Pruritus in Patients Undergoing Haemodialysis—A Cross-Sectional Study
title_fullStr Chronic Kidney Disease-Associated Pruritus in Patients Undergoing Haemodialysis—A Cross-Sectional Study
title_full_unstemmed Chronic Kidney Disease-Associated Pruritus in Patients Undergoing Haemodialysis—A Cross-Sectional Study
title_short Chronic Kidney Disease-Associated Pruritus in Patients Undergoing Haemodialysis—A Cross-Sectional Study
title_sort chronic kidney disease associated pruritus in patients undergoing haemodialysis a cross sectional study
topic chronic kidney disease-associated pruritus
prevalence
outcomes
factors
severity
url https://www.mdpi.com/1648-9144/61/6/993
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