Abstract
Uremic pruritus (UP) is a multifactorial problem that contributes to low quality of life in dialysis patients. The long-term influences of UP on dialysis patients are still poorly understood. This study aims to elucidate the contribution of UP to long-term outcomes. We used the Taiwan National Health Insurance Research Database to conduct this study. Patients on chronic dialysis were included and divided into UP and non-UP groups according to the long-term prescription of antihistamine in the absence of other indications. The outcomes include infection-related hospitalization, catheter-related infection, major adverse cardiac and cerebrovascular events (MACCE) and parathyroidectomy. After propensity score matching, 14,760 patients with UP and 29,520 patients without UP were eligible for analysis. After a mean follow-up of 5 years, we found that infection-related hospitalization, MACCE, catheter-related infection, heart failure and parathyroidectomy were all slightly higher in the UP than non-UP group (hazard ratio: 1.18 [1.16-1.21], 1.05 [1.01-1.09], 1.16 [1.12-1.21], 1.08 [1.01-1.16] and 1.10 [1.01-1.20], respectively). Subgroup analysis revealed that the increased risk of adverse events by UP was generally more apparent in younger patients and patients who underwent peritoneal dialysis. UP may be significantly associated with an increased risk of long-term morbidities.
Highlights
Uremic pruritus (UP) is a common problem among patients with advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) receiving chronic dialysis [1,2,3]
After a mean follow-up of 5 years, we found that infection-related hospitalization, major adverse cardiac and cerebrovascular events (MACCE), catheter-related infection, heart failure and parathyroidectomy were all slightly higher in the UP than non-UP group
Subgroup analysis revealed that the increased risk of adverse events by UP was generally more apparent in younger patients and patients who underwent peritoneal dialysis
Summary
Uremic pruritus (UP) is a common problem among patients with advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) receiving chronic dialysis [1,2,3]. NHIRD is not free to public access, and interested researchers can obtain the data through formal application to the HWDC, Department of Statistics, Ministry of Health and Welfare, Taiwan (http://dep.mohw.gov.tw/DOS/np-2497-113.html). The authors had no special access privileges that others would not have. Uremic pruritus (UP) is a multifactorial problem that contributes to low quality of life in dialysis patients. The long-term influences of UP on dialysis patients are still poorly understood. This study aims to elucidate the contribution of UP to long-term outcomes
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