Uremic pruritus is associated with higher Kt/V and serum calcium concentration

M. I. Duque, S. Thevarajah, Y. H. Chan, A. B. Tuttle, B. I. Freedman, G. Yosipovitch

Research output: Contribution to journalArticle

59 Scopus citations

Abstract

Background: The prevalence and characteristics of uremic pruritus have not recently been investigated in a US dialysis cohort. This study examined uremic pruritus and associated risk factors in hemodialysis patients treated in the year 2005. Methods: The prevalence and characteristics of pruritus (short version McGill pain questionnaire), severity (10 cm visual analogue scale), and effect on quality of life (Skindex-16) were determined in thrice weekly hemodialysis patients. Daugirdas single-pool Kt/V, clinical and laboratory data were recorded. Results: 105 of 307 screened hemodialysis patients met inclusion criteria and were evaluated, 49% (151) were excluded due to advanced age, 3% (9) other skin diseases, and 14% (42) refused. Participants were 55% male (58/105) and 65% African-American (68) with a mean ± SD age of 48 ± 11 years. The overall prevalence of pruritus was 57% (60/105, 95% CI 47-67%) and a positive correlation was observed between the presence of uremic itch and serum calcium concentration (p = 0.04). Intact PTH and serum phosphorus concentration were not associated with either the presence or intensity of itch. Intensity of pruritus was positively correlated with increasing months on dialysis (64 ± 63 vs. 51 ± 46 months for itch and non-itch, respectively; p = 0.02), higher Kt/V (1.82 ± 0.7 vs. 1.70 ± 0.56 for itch and non-itch, respectively; p = 0.01) and skin dryness (p = 0.01). Patients receiving statins were significantly less likely to report pruritus (p = 0.02) and uremic itch adversely impacted several aspects of quality of life. Conclusions: Pruritus remains a common and significant symptom in adequately hemodialyzed patients. Higher serum calcium concentrations, longer durations of ESRD and higher Kt/V appear to be important factors associated with uremic pruritus.

Original languageEnglish (US)
Pages (from-to)184-191
Number of pages8
JournalClinical Nephrology
Volume66
Issue number3
StatePublished - Sep 1 2006
Externally publishedYes

Keywords

  • Dermatology
  • End-stage
  • Hemodialysis
  • Pruritus
  • Quality of life
  • Renal disease

ASJC Scopus subject areas

  • Nephrology

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    Duque, M. I., Thevarajah, S., Chan, Y. H., Tuttle, A. B., Freedman, B. I., & Yosipovitch, G. (2006). Uremic pruritus is associated with higher Kt/V and serum calcium concentration. Clinical Nephrology, 66(3), 184-191.