Abstract
BackgroundPruritus is a distressing, life-limiting symptom in chronic renal failure, affecting 40% of patients. This study aimed to determine uremic pruritus prevalence and investigate the multidimensional impact on hemodialysis patients.MethodsThis descriptive study was performed between March and June 2016. The study included 181 patients undergoing hemodialysis session, who reported pruritus in the prior month. Data were collected using the 5-D Itch Scale, which assesses pruritus based on 5 dimensions, i.e., degree, duration, direction, disability, and distribution, with a total score ranging from 5 (no itching) to 25 (maximum severity).ResultsPruritus prevalence was 49.3%. Patients had a mean score of 13.97 ± 4.11 (moderate severity). The daily duration was 6–12 h (40.3%), with direction “a little bit better but still present” (38.7%) and distribution on the “back, upper arms, chest, and abdomen.” Patients sleep, social life/leisure time, housework and errand were impacted “occasionally”. The score was higher in patients aged ≥65 years, those on hemodialysis for ≥15 or more years, and those undergoing afternoon hemodialysis. The duration of itching was significantly shorter in employed patients.ConclusionAssessment and management of itching symptoms in chronic renal failure are a clinical priority both for patients and for health care professionals. The results of this study highlight the importance of multidimensional assessment and support the need for development of standardized and patient-specific symptom management.
Highlights
Pruritus is a distressing, life-limiting symptom in chronic renal failure, affecting 40% of patients
– What is the prevalence of uremic pruritus? – What are the characteristics of pruritus symptoms in chronic renal failure (CRF) patients according to degree, duration, direction, disability/impact on activities of daily living, and distribution? – What are the associations between pruritus and patient clinical features and dialysis parameters?
While nocturnal uremic pruritus was commonly reported in a study of 145 hemodialysis patients, 39.3% had day-long symptoms [23]
Summary
Life-limiting symptom in chronic renal failure, affecting 40% of patients. Uremic pruritus has a multifactorial etiopathogenesis, and is associated with physical disability, impaired quality of life, and limitations in activities of daily living [4, 5]. Uremic pruritus is strongly associated with physical and mental limitations, insomnia, and chronic fatigue; discomfort, embarrassment/isolation, and secondary skin changes due to scratching of lesions; and anger, anxiety, and depression [6,7,8]. As further multifaceted paradigm of itching taken into consideration, assessment of care and treatment success be evaluated within numerous dimensions. This time and individual sensitive approach helps to screen and record the changes over time [9]
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