Physician Awareness, Prevalence of Pruritus in Patients Receiving Hemodialysis

Pruritus associated with CKD (CKD-aP) may be under-recognized in patients with impaired kidney function. Franziska Engler and colleagues conducted a study to examine the prevalence, risk factors, and impacts on quality of life (QOL) of CKD-aP in a cohort of patients receiving hemodialysis in Austria. The researchers also sought to assess attending physicians’ awareness of and approach to therapy for pruritus. 

The study utilized responses on patient and physician questionnaires on pruritus severity and QOL linked with information from the Austrian Dialysis and Transplant Registry. 

In the cohort of 962 patients, 34.4% reported mild pruritus, 11.4% reported moderate pruritus, and 4.3% reported severe pruritus. The physicians’ estimated prevalences were 25.0%, 14.4%, and 6.3%, respectively. The estimated national prevalence estimate extrapolated from the study cohort was 45.0% for any stage, 13.9% for moderate, and 4.2% for severe CKD-aP. Severity was significantly associated with impaired QOL. 

The risk factors for CKD-aP were identified as higher C-reactive protein (OR, 1.61; 95% CI, 1.07-2.43) and parathyroid hormone (PTH) values (OR, 1.50; 95% CI, 1.00-2.27). Therapy included changes in the dialysis regimen, topical treatment, antihistamines, gabapentin and pregabalin, and phototherapy. 

In summary, the authors said, “While the prevalence of CKD-aP in our study was similar to that in previously published literature, the prevalence of moderate-to-severe pruritus is lower. CKD-aP was associated with reduced QOL and elevated markers of inflammation and PTH. The high awareness of CKD-aP in Austrian nephrologists may explain the lower prevalence of more severe pruritus.” 

Source: Nephrology Dialysis Transplantation