Comparison of uremic pruritus between patients undergoing hemodialysis and peritoneal dialysis

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• 作者：Ji-Won Min¹ ; Su-Hyun Kim² ; Young Ok Kim¹ ; Dong Chan Jin¹ ; Ho Chul Song¹ ; Euy Jin Choi¹ ; Yong-Lim Kim³ ; Yon-Su Kim⁴ ; Shin-Wook Kang⁵ ; Nam-Ho Kim⁶ ; Chul Woo Yang¹ ; Yong Kyun Kim¹ ; ^{drkimyk@catholic.ac.kr" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Hemodialysis ; Peritoneal dialysis ; Uremic pruritus
• 刊名：Kidney Research and Clinical Practice
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：35
• 期：2
• 页码：107-113
• 全文大小：300 K

文摘

Uremic pruritus is a common, but unpleasant, complication of end-stage renal disease. The uremic burden may differ between hemodialysis (HD) and peritoneal dialysis (PD) patients. This difference may also change the clinical characteristics of uremic pruritus between the 2 modalities. In this study, we investigated the uremic pruritus between patients on HD and PD.

Methods

A total of 425 HD and 223 PD patients from the Clinical Research Center registry in Korea were included. Patients were assessed for pruritus intensity, scratching activity, pruritus distribution, and frequency of pruritus-related sleep disturbance using the visual analog scale and questionnaire.

Results

The prevalence of uremic pruritus was higher in PD patients than that in HD patients (62.6% vs. 48.3%, P = 0.001). In the multivariable logistic analysis, PD treatment was significantly associated with the prevalence of uremic pruritus (odds ratio, 1.76; 95% confidence interval, 1.20–2.57, P = 0.004) after adjustment for clinical variables. The visual analog scale score, representing a subjective intensity of itchiness, was significantly higher in PD patients (PD 2.11 ± 2.32 vs. HD 1.65 ± 2.28, P = 0.013) compared with HD patients. The intensity of uremic pruritus was independently related with serum albumin levels (β = –0.143, P = 0.006) in HD patients and total weekly Kt/V (β = –0.176, P = 0.028) in PD patients.

Conclusion

Our data demonstrate the difference in prevalence, intensity, and risk factors of uremic pruritus between HD and PD patients. These findings suggest that careful consideration for uremic pruritus might be needed in end-stage renal disease patients according to the dialysis modality.