Details

Autor(en) / Beteiligte

• Kimata, Naoki
• Fuller, Douglas S.
• Saito, Akira
• Akizawa, Tadao
• Fukuhara, Shunichi
• Pisoni, Ronald L.
• Robinson, Bruce M.
• Akiba, Takashi

Titel

Pruritus in hemodialysis patients: Results from the J apanese D ialysis O utcomes and P ractice P atterns S tudy ( JDOPPS )

Ist Teil von

• Hemodialysis international, 2014-07, Vol.18 (3), p.657-667

Erscheinungsjahr

2014

Link zum Volltext

Quelle

Wiley Online Library - AutoHoldings Journals

Beschreibungen/Notizen

• Abstract Pruritus affects many patients undergoing hemodialysis ( HD ). In this study, pruritus and its relationship to morbidity, quality of life ( QoL ), sleep quality, and patient laboratory measures were analyzed in a large sample of J apanese patients undergoing HD . Severity of patient‐reported pruritus symptoms experienced during a 4‐week period was collected from 6480 J apanese patients undergoing HD in three phases of the D ialysis O utcomes and P ractice P atterns S tudy ( DOPPS ; 1996–2008; 60–65 study facilities/phase). Adjusted linear and logistic regressions were used to identify associations of pruritus with treatment parameters and QoL outcomes. Adjusted C ox regressions examined the influence of pruritus severity on mortality. Moderate to extreme pruritus was experienced by 44% of prevalent patients undergoing HD in the J apanese D ialysis O utcomes and P ractice P atterns S tudy. Many patient characteristics were significantly associated with pruritus, but this did not explain the large differences in pruritus among facilities (20–70%). Pruritus was slightly less common in patients starting HD than in patients on dialysis >1 year. Patients with moderate to extreme pruritus were more likely to feel drained (adjusted odds ratio = 2.2–5.8, P < 0.0001), have poor sleep quality (adjusted odds ratio = 1.9–3.7, P < 0.0001), and have QoL mental and physical composite scores 2.3–6.7 points lower (P < 0.0001) than patients with no/mild pruritus. Pruritus in patients undergoing HD was associated with a 23% higher mortality risk (P = 0.09). The many poor outcomes associated with pruritus underscore the need for better therapeutic agents to provide relief for the 40–50% of prevalent patients undergoing HD substantially affected by pruritus. Pruritus in new patients with end‐stage renal disease likely results from uremia or pre‐existing conditions (not HD per se), indicating the need to understand development of pruritus before end‐stage renal disease.