Abstract
Introduction: Pruritus is one of the well-recognized major skin derangements in patients with advanced renal failure and are usually without visible skin lesions. Only few studies have addressed this issue in Nepalese population.
 Objective:.The present study aims to identify the prevalence and associated factors of uremic pruritus in chronic dialysis patients in western Nepal.
 Methodology:A prospective observational study was conducted to include all chronic dialysis patients with uremic pruritus at the Manipal Teaching Hospital, Pokhara, Nepal over a period of one year (June 2018 and May 2019).
 Results: During the study period, a total of 59 patients were included in the study with mean age of 55.8±15.8years,of which 37 (63%) patients developed uremic pruritus.
 Statistically significant relationship betweenpresence of pruritus and pruritus severity with frequency of itching grade and sleep disturbance score among elderly (p=0.001) were observed
 The serum urea can predict uremic pruritus among elderly patients with a good diagnostic value. The multivariate analysis showed male gender, hypertension, elevated serum albumin and random blood sugarwere independent predictors of pruritus in patients undergoing chronic dialysis.
 Conclusions: Our findings demonstrate that higher proportion ofpatients undergoing chronic dialysis werediagnosed with uremic pruritus (63%) and occurrence of pruritus had association with frequency of itching grade and sleep disturbance score .The serum levels of urea may predict the occurrence of pruritus among elderly patients.Furthermore, a large multicenter study is warranted with longer follow up which may provide robust information on the burden of pruritus and its associated factors to guide appropriate management among elderly.
Highlights
Pruritus is one of the well-recognized major skin derangements in pa ents with advanced renal failure and is usually iden fied without visible skin lesions.[1,2] Other cutaneous manifesta ons of pa ents on dialysis are xerosis, hyper pigmenta on, reac ve perfora ng collagenosis, mucosal, hair and nail changes
Our findings demonstrate that higher propor on of pa ents undergoing chronic dialysis were diagnosed with uremic pruritus (63%) and occurrence of pruritus had associa on with frequency of itching grade and sleep disturbance score
The present study aims to iden fy the prevalence and associated factors of uremic pruritus in chronic dialysis pa ents in western Nepal, with specific focus on the elderly popula on in Nepal
Summary
Pruritus is one of the well-recognized major skin derangements in pa ents with advanced renal failure and is usually iden fied without visible skin lesions.[1,2] Other cutaneous manifesta ons of pa ents on dialysis are xerosis, hyper pigmenta on, reac ve perfora ng collagenosis, mucosal, hair and nail changes. An earlier study reported the global prevalence of uremic pruritus (moderate or extreme) to be 42%, and suggested asignificant associa on of uremic pruritus with depression, sleeping disorders, impaired quality of life and death.[3] In Nepal, the prevalence of pruritus among chronic kidney disease pa ents undergoing dialysis was es mated to be 40-55%.4,5. Even though since long me evidence exists for the rela onship between chronic renal failure and pruritus, its molecular basis remains controversial, considering the subjec ve nature and strong influence of psychological factors.[6] there is paucity of informa on on the prevalence of uremic pruritus in chronic kidney disease pa ents from the western part of Nepal. The present study aims to iden fy the prevalence and associated factors of uremic pruritus in chronic dialysis pa ents in western Nepal, with specific focus on the elderly popula on in Nepal
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