This article is more than 5 years old. Information may no longer be current.

Uremic pruritis contributes to adverse long-term outcomes for patients on dialysis

An association was found between uremic pruritis and adverse long-term outcomes for patients on dialysis, according to a study published in the Journal of the American Academy of Dermatology.

“We designed this prospective open cohort study using retrospectively collected data from the Taiwan National Health Insurance Research Database (NHIRD),” Sze-Wen Ting, MD, of the department of dermatology at Linkou Chang Gung Memorial Hospital in Taiwan, and colleagues wrote.

Diagnosis of uremic pruritus was defined in patients who received more than 42 daily doses of antihistamine or received ultraviolet B phototherapy within 1 year after initiation of dialysis. Clinical characteristics of uremic pruritus and non-uremic pruritus groups were balanced through propensity score matching.

In total, 25,048 patients with uremic pruritus and 50,096 without uremic pruritus were matched and analyzed. After a mean follow-up period of 5 years, it was found that the uremic pruritus group had a higher risk for all-cause mortality (HR = 1.05; 95% CI, 1.03-1.07), cardiovascular death (HR = 1.06; 95% CI, 1.02-1.09) and infection-related death (HR = 1.08; 95% CI, 1.05-1.11).

These results showed that frequent association of uremic pruritus with inadequate uremic toxin removal, hyperphosphatemia and fluid overload can contribute to an increased risk for cardiovascular events for patients on dialysis.

“Our effort on using a treatment-based criterion to identify patients with uremic pruritus can sort out the group with more intense pruritus, and this may be similar to those with a high visual analogue score of itching,” the researchers wrote. “However, the previously reported association between higher visual analogue score regarding pruritis intensity and worse outcome was not observed in a recent cohort study in Taiwan.”

Researchers highlight the need for a better scoring system to be developed. – by Erin T. Welsh

Disclosures: The authors report no relevant financial disclosures.