CKD-associated pruritus often poorly treated, may disrupt dialysis even when reported
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Key takeaways:
- Overall, 49% of patients on dialysis reported moderate itch, 30% had severe itch and 22% had mild itch.
- In addition, 68% of patients reported symptoms to health care providers.
Chronic kidney disease-associated pruritus may often be insufficiently treated and can disrupt dialysis treatment for patients who report itch to health care providers.
Persistent itching can “significantly impact the quality of life for individuals with CKD,” Jeffrey Thompson, PhD, of Oracle Life Sciences in Austin, Texas, wrote with colleagues. “Patient surveys and epidemiological studies showed [CKD–associated pruritus] CKD-aP is common and often severe, with an overall prevalence of up to 80% in end stage kidney disease (ESKD) patients, and a prevalence of up to 40% for moderate to severe CKD-aP.”
In a cross-sectional study, researchers evaluated data from 354 patients with CKD-associated pruritus, 49% with moderate itch, 30% with severe itch and 22% with mild itch. The patient-reported online survey used data from U.S. adults on hemodialysis from 2021 to 2022. Self-reported measures included itch attributes, symptom management, health care provider engagement, as well as the impact on hemodialysis, quality of life, sleep and work.
Overall, 68% of patients reported symptoms to health care providers, with nephrologists or primary care providers at the top of the list; and 55% received a treatment suggestion.
Topical lotions or moisturizers (75%) and corticosteroids (48%) were most commonly prescribed, while 20% of patients used oral prescriptions and reported limited satisfaction.
Thompson and colleagues found 23% of patients had shortening of and 17% missed hemodialysis sessions due to itch. Patients with more severe CKD-associated pruritus experienced worse disease and had worse function, including kidney disease score, cognitive function, quality of social interaction, sleep and sexual function.
“These findings provide additional insights into the impact of CKD-aP on patients’ interactions with [health care providers] their treatment journey, symptom management, work productivity and overall [quality of life],” Thompson and colleagues wrote. Further, “it identifies an opportunity for improvement of [hemodialysis] adherence by diagnosing and treating pruritus earlier and more effectively.”
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