Abstract
Chronic-kidney-disease-associated pruritus (CKD-aP) is one of the most common and burdensome dermatological symptoms affecting patients undergoing dialysis, and its etiopathogenesis has still not been fully discovered. This study was designed to investigate the possible contribution of interleukin-31 (IL-31) to the pathogenesis of itch in patients undergoing maintenance hemodialysis (HD). We evaluated the serum level of IL-31 in HD patients with pruritus, in HD patients without pruritus and in healthy controls, as well as its correlation to the severity of itch. The study enrolled 175 adult subjects. The participants were divided into three groups. Group A included 64 patients on maintenance HD with CKD-aP, Group B included 62 patients on maintenance HD not reporting CKD-aP and Group C included 49 healthy controls. Pruritus severity was assessed using the Numerical Rating Scale (NRS), and the serum levels of IL-31 were measured. The results showed that the IL-31 serum level was significantly higher in the itchy group (p < 0.001) in comparison to the patients free from pruritus. Moreover, a marginal trend towards significance (r = 0.242, p = 0.058) was observed between the IL-31 serum level and itch intensity. Our study supports earlier findings on the extended role of IL-31 in the development of CKD-aP.
Highlights
Chronic-kidney-disease-associated pruritus (CKD-aP) is one of the most common and burdensome dermatological symptoms affecting patients undergoing dialysis
In the group of HD patients suffering from chronic kidney disease (CKD)-aP, 50% were males, and the average age was 61.1 ± 15.9 years
In 58% of the CKD-aP patients, itch interfered with their sleep, and only 29% did not report the influence of itch on the following activities: work or study, social interaction, mood or any sexual activities
Summary
Chronic-kidney-disease-associated pruritus (CKD-aP) is one of the most common and burdensome dermatological symptoms affecting patients undergoing dialysis. The prevalence of CKD-aP has been very variable over the years, yet according to the most comprehensive observational study of hemodialysis (HD) that included patients from 12 different countries, approximately 40% of patients with end-stage renal disease (ESRD) report moderate-to-severe pruritus [1]. Despite the high international prevalence, this problem seems to be markedly underestimated in clinical practice. The reason for this trend may be the lack of knowledge regarding effective therapies for CKD-aP [4]. Further research in the field of the pathophysiology of CKD-aP may lead to a revolution in the therapeutic management of HD patients suffering from pruritus
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