Skip to main content
Top
Gepubliceerd in:

01-05-2012

Assessment of the psychological burden associated with pruritus in hemodialysis patients using the kidney disease quality of life short form

Auteurs: Gildete Barreto Lopes, Fernanda Conceição Pereira Nogueira, Milena Reis de Souza, Maria Auxiliadora Penalva, Josete Leão de Amorim, Ronald L. Pisoni, Bruce M. Robinson, Antonio Alberto Lopes

Gepubliceerd in: Quality of Life Research | Uitgave 4/2012

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

Purpose

To assess whether depression symptoms, poor sleep and dry skin bother explain association between pruritus and the burden of kidney disease in maintenance hemodialysis (MHD) patients.

Methods

Cross-sectional study of 980 patients from a prospective study in dialysis units of Salvador, Brazil (PROHEMO). The Kidney Disease Quality of Life Short Form was used to determine scores of kidney disease burden (KDB) and sleep with higher scores indicating lower perceived burden and better sleep quality, respectively. The Center for Epidemiological Studies Depression Scale was used for depression symptoms.

Results

Prevalence of severe pruritus (very much or extreme) was 19.4%. Significantly (P < 0.001) lower mean KDB score by 11.44 points was observed for patients with severe pruritus (34.18 ± 27.51) than for those with no pruritus (45.62 ± 30.73). Severe pruritus was associated with poorer sleep quality, higher odds of dry skin bother and higher depression symptoms score. Association of pruritus with KDB score was virtually eliminated after adjustment for sleep, dry skin bother and depression symptoms.

Conclusions

This study shows strong associations of severe pruritus with higher depression symptoms, poorer sleep and dry skin bother among MHD patients. The results support special attention to MHD patients with pruritus who often face high psychological burden.
Literatuur
1.
go back to reference Merkus, M. P., Jager, K. J., Dekker, F. W., de Haan, R. J., Boeschoten, E. W., & Krediet, R. T. (1999). Physical symptoms and quality of life in patients on chronic dialysis: Results of The Netherlands Cooperative Study on Adequacy of Dialysis (NECOSAD). Nephrology, Dialysis, Transplantation, 14(5), 1163–1170.CrossRef Merkus, M. P., Jager, K. J., Dekker, F. W., de Haan, R. J., Boeschoten, E. W., & Krediet, R. T. (1999). Physical symptoms and quality of life in patients on chronic dialysis: Results of The Netherlands Cooperative Study on Adequacy of Dialysis (NECOSAD). Nephrology, Dialysis, Transplantation, 14(5), 1163–1170.CrossRef
2.
go back to reference Patel, T. S., Freedman, B. I., & Yosipovitch, G. (2007). An update on pruritus associated with CKD. American Journal of Kidney Diseases, 50(1), 11–20.PubMedCrossRef Patel, T. S., Freedman, B. I., & Yosipovitch, G. (2007). An update on pruritus associated with CKD. American Journal of Kidney Diseases, 50(1), 11–20.PubMedCrossRef
3.
go back to reference Pisoni, R. L., Wikstrom, B., Elder, S. J., Akizawa, T., Asano, Y., Keen, M. L., et al. (2006). Pruritus in haemodialysis patients: International results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrology, Dialysis, Transplantation, 21(12), 3495–3505.PubMedCrossRef Pisoni, R. L., Wikstrom, B., Elder, S. J., Akizawa, T., Asano, Y., Keen, M. L., et al. (2006). Pruritus in haemodialysis patients: International results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrology, Dialysis, Transplantation, 21(12), 3495–3505.PubMedCrossRef
4.
go back to reference Mathur, V. S., Lindberg, J., Germain, M., Block, G., Tumlin, J., Smith, M., et al. (2010). A longitudinal study of uremic pruritus in hemodialysis patients. Clinical Journal of the American Society of Nephrology, 5(8), 1410–1419.CrossRef Mathur, V. S., Lindberg, J., Germain, M., Block, G., Tumlin, J., Smith, M., et al. (2010). A longitudinal study of uremic pruritus in hemodialysis patients. Clinical Journal of the American Society of Nephrology, 5(8), 1410–1419.CrossRef
5.
go back to reference Melo, N. C., Elias, R. M., Castro, M. C., Romao, J. E., Jr., & Abensur, H. (2009). Pruritus in hemodialysis patients: The problem remains. Hemodialysis International, 13(1), 38–42.PubMedCrossRef Melo, N. C., Elias, R. M., Castro, M. C., Romao, J. E., Jr., & Abensur, H. (2009). Pruritus in hemodialysis patients: The problem remains. Hemodialysis International, 13(1), 38–42.PubMedCrossRef
6.
go back to reference Szepietowski, J. C., Reich, A., & Schwartz, R. A. (2004). Uraemic xerosis. Nephrology, Dialysis, Transplantation, 19(11), 2709–2712.CrossRef Szepietowski, J. C., Reich, A., & Schwartz, R. A. (2004). Uraemic xerosis. Nephrology, Dialysis, Transplantation, 19(11), 2709–2712.CrossRef
7.
go back to reference Szepietowski, J. C., Balaskas, E., Taube, K. M., Taberly, A., & Dupuy, P. (2011). Quality of life in patients with uraemic xerosis and pruritus. Acta Dermato-Venereologica, 91(3), 313–317.CrossRef Szepietowski, J. C., Balaskas, E., Taube, K. M., Taberly, A., & Dupuy, P. (2011). Quality of life in patients with uraemic xerosis and pruritus. Acta Dermato-Venereologica, 91(3), 313–317.CrossRef
8.
go back to reference Yamamoto, Y., Hayashino, Y., Yamazaki, S., Akiba, T., Akizawa, T., Asano, Y., et al. (2009). Depressive symptoms predict the future risk of severe pruritus in haemodialysis patients: Japan Dialysis Outcomes and Practice Patterns Study. British Journal of Dermatology, 161(2), 384–389.CrossRef Yamamoto, Y., Hayashino, Y., Yamazaki, S., Akiba, T., Akizawa, T., Asano, Y., et al. (2009). Depressive symptoms predict the future risk of severe pruritus in haemodialysis patients: Japan Dialysis Outcomes and Practice Patterns Study. British Journal of Dermatology, 161(2), 384–389.CrossRef
9.
go back to reference Winkelman, J. W., Chertow, G. M., & Lazarus, J. M. (1996). Restless legs syndrome in end-stage renal disease. American Journal of Kidney Diseases, 28(3), 372–378.CrossRef Winkelman, J. W., Chertow, G. M., & Lazarus, J. M. (1996). Restless legs syndrome in end-stage renal disease. American Journal of Kidney Diseases, 28(3), 372–378.CrossRef
10.
go back to reference Lopes, G. B., Matos, C. M., Leite, E. B., Martins, M. T., Martins, M. S., Silva, L. F., et al. (2010). Depression as a potential explanation for gender differences in health-related quality of life among patients on maintenance hemodialysis. Nephron Clinical Practice, 115(1), c35–c40.PubMedCrossRef Lopes, G. B., Matos, C. M., Leite, E. B., Martins, M. T., Martins, M. S., Silva, L. F., et al. (2010). Depression as a potential explanation for gender differences in health-related quality of life among patients on maintenance hemodialysis. Nephron Clinical Practice, 115(1), c35–c40.PubMedCrossRef
11.
go back to reference Hays, R. D., Kallich, J. D., Mapes, D. L., Coons, S. J., & Carter, W. B. (1994). Development of the kidney disease quality of life (KDQOL) instrument. Quality of Life Research, 3(5), 329–338.PubMedCrossRef Hays, R. D., Kallich, J. D., Mapes, D. L., Coons, S. J., & Carter, W. B. (1994). Development of the kidney disease quality of life (KDQOL) instrument. Quality of Life Research, 3(5), 329–338.PubMedCrossRef
12.
go back to reference Silveira, D. X., & Jorge, M. R. (1998). Propriedades psicométricas da escala de rastreamento populacional para depressão CES-D em populações clínica e não clínica de adolescentes e adultos jovens. Psiq Clin, 25, 251–261. Silveira, D. X., & Jorge, M. R. (1998). Propriedades psicométricas da escala de rastreamento populacional para depressão CES-D em populações clínica e não clínica de adolescentes e adultos jovens. Psiq Clin, 25, 251–261.
13.
go back to reference Hedayati, S. S., Bosworth, H. B., Kuchibhatla, M., Kimmel, P. L., & Szczech, L. A. (2006). The predictive value of self-report scales compared with physician diagnosis of depression in hemodialysis patients. Kidney International, 69(9), 1662–1668.PubMedCrossRef Hedayati, S. S., Bosworth, H. B., Kuchibhatla, M., Kimmel, P. L., & Szczech, L. A. (2006). The predictive value of self-report scales compared with physician diagnosis of depression in hemodialysis patients. Kidney International, 69(9), 1662–1668.PubMedCrossRef
14.
go back to reference K/DOQI. (2006). Clinical practice guidelines for hemodialysis adequacy, update 2006. American Journal of Kidney Diseases, 48(Suppl 1), S2–S90. K/DOQI. (2006). Clinical practice guidelines for hemodialysis adequacy, update 2006. American Journal of Kidney Diseases, 48(Suppl 1), S2–S90.
15.
go back to reference Rambod, M., Bross, R., Zitterkoph, J., Benner, D., Pithia, J., Colman, S., et al. (2009). Association of malnutrition-inflammation score with quality of life and mortality in hemodialysis patients: A 5-year prospective cohort study. American Journal of Kidney Diseases, 53(2), 298–309.PubMedCrossRef Rambod, M., Bross, R., Zitterkoph, J., Benner, D., Pithia, J., Colman, S., et al. (2009). Association of malnutrition-inflammation score with quality of life and mortality in hemodialysis patients: A 5-year prospective cohort study. American Journal of Kidney Diseases, 53(2), 298–309.PubMedCrossRef
16.
go back to reference Kaysen, G. A., Greene, T., Daugirdas, J. T., Kimmel, P. L., Schulman, G. W., Toto, R. D., et al. (2003). Longitudinal and cross-sectional effects of C-reactive protein, equilibrated normalized protein catabolic rate, and serum bicarbonate on creatinine and albumin levels in dialysis patients. American Journal of Kidney Diseases, 42(6), 1200–1211.PubMedCrossRef Kaysen, G. A., Greene, T., Daugirdas, J. T., Kimmel, P. L., Schulman, G. W., Toto, R. D., et al. (2003). Longitudinal and cross-sectional effects of C-reactive protein, equilibrated normalized protein catabolic rate, and serum bicarbonate on creatinine and albumin levels in dialysis patients. American Journal of Kidney Diseases, 42(6), 1200–1211.PubMedCrossRef
17.
go back to reference Vernaglione, L., Marangi, A. L., Cristofano, C., Giordano, R., Chimienti, S., & Basile, C. (2003). Predictors of serum creatinine in haemodialysis patients: A cross-sectional analysis. Nephrology, Dialysis, Transplantation, 18(6), 1209–1213.PubMedCrossRef Vernaglione, L., Marangi, A. L., Cristofano, C., Giordano, R., Chimienti, S., & Basile, C. (2003). Predictors of serum creatinine in haemodialysis patients: A cross-sectional analysis. Nephrology, Dialysis, Transplantation, 18(6), 1209–1213.PubMedCrossRef
18.
go back to reference Balaskas, E., Szepietowski, J. C., Bessis, D., Ioannides, D., Ponticelli, C., Ghienne, C., et al. (2011). Randomized, double-blind study with glycerol and paraffin in uremic xerosis. Clinical Journal of the American Society of Nephrology, 6(4), 748–752.PubMedCrossRef Balaskas, E., Szepietowski, J. C., Bessis, D., Ioannides, D., Ponticelli, C., Ghienne, C., et al. (2011). Randomized, double-blind study with glycerol and paraffin in uremic xerosis. Clinical Journal of the American Society of Nephrology, 6(4), 748–752.PubMedCrossRef
19.
go back to reference Park, T. H., Park, C. H., Ha, S. K., Lee, S. H., Song, K. S., Lee, H. Y., et al. (1995). Dry skin (xerosis) in patients undergoing maintenance haemodialysis: The role of decreased sweating of the eccrine sweat gland. Nephrology, Dialysis, Transplantation, 10(12), 2269–2273.PubMed Park, T. H., Park, C. H., Ha, S. K., Lee, S. H., Song, K. S., Lee, H. Y., et al. (1995). Dry skin (xerosis) in patients undergoing maintenance haemodialysis: The role of decreased sweating of the eccrine sweat gland. Nephrology, Dialysis, Transplantation, 10(12), 2269–2273.PubMed
20.
go back to reference Momose, A., Kudo, S., Sato, M., Saito, H., Nagai, K., Katabira, Y., et al. (2004). Calcium ions are abnormally distributed in the skin of haemodialysis patients with uraemic pruritus. Nephrology, Dialysis, Transplantation, 19(8), 2061–2066.PubMedCrossRef Momose, A., Kudo, S., Sato, M., Saito, H., Nagai, K., Katabira, Y., et al. (2004). Calcium ions are abnormally distributed in the skin of haemodialysis patients with uraemic pruritus. Nephrology, Dialysis, Transplantation, 19(8), 2061–2066.PubMedCrossRef
21.
go back to reference Manenti, L., Tansinda, P., & Vaglio, A. (2009). Uraemic pruritus: Clinical characteristics, pathophysiology and treatment. Drugs, 69(3), 251–263.PubMedCrossRef Manenti, L., Tansinda, P., & Vaglio, A. (2009). Uraemic pruritus: Clinical characteristics, pathophysiology and treatment. Drugs, 69(3), 251–263.PubMedCrossRef
22.
go back to reference Chiu, Y. L., Chen, H. Y., Chuang, Y. F., Hsu, S. P., Lai, C. F., Pai, M. F., et al. (2008). Association of uraemic pruritus with inflammation and hepatitis infection in haemodialysis patients. Nephrology, Dialysis, Transplantation, 23(11), 3685–3689.PubMedCrossRef Chiu, Y. L., Chen, H. Y., Chuang, Y. F., Hsu, S. P., Lai, C. F., Pai, M. F., et al. (2008). Association of uraemic pruritus with inflammation and hepatitis infection in haemodialysis patients. Nephrology, Dialysis, Transplantation, 23(11), 3685–3689.PubMedCrossRef
23.
go back to reference Kimmel, M., Alscher, D. M., Dunst, R., Braun, N., Machleidt, C., Kiefer, T., et al. (2006). The role of micro-inflammation in the pathogenesis of uraemic pruritus in haemodialysis patients. Nephrology, Dialysis, Transplantation, 21(3), 749–755.PubMedCrossRef Kimmel, M., Alscher, D. M., Dunst, R., Braun, N., Machleidt, C., Kiefer, T., et al. (2006). The role of micro-inflammation in the pathogenesis of uraemic pruritus in haemodialysis patients. Nephrology, Dialysis, Transplantation, 21(3), 749–755.PubMedCrossRef
24.
go back to reference Virga, G., Visentin, I., La Milia, V., & Bonadonna, A. (2002). Inflammation and pruritus in haemodialysis patients. Nephrology, Dialysis, Transplantation, 17(12), 2164–2169.PubMedCrossRef Virga, G., Visentin, I., La Milia, V., & Bonadonna, A. (2002). Inflammation and pruritus in haemodialysis patients. Nephrology, Dialysis, Transplantation, 17(12), 2164–2169.PubMedCrossRef
25.
go back to reference Gupta, M. A., Gupta, A. K., Schork, N. J., & Ellis, C. N. (1994). Depression modulates pruritus perception: A study of pruritus in psoriasis, atopic dermatitis, and chronic idiopathic urticaria. Psychosomatic Medicine, 56(1), 36–40.PubMed Gupta, M. A., Gupta, A. K., Schork, N. J., & Ellis, C. N. (1994). Depression modulates pruritus perception: A study of pruritus in psoriasis, atopic dermatitis, and chronic idiopathic urticaria. Psychosomatic Medicine, 56(1), 36–40.PubMed
26.
go back to reference Gupta, M. A., Gupta, A. K., Kirkby, S., Schork, N. J., Weiner, H. K., Ellis, C. N., et al. (1989). Pruritus associated with nocturnal wakenings: Organic or psychogenic? Journal of the American Academy of Dermatology, 21(3 Pt 1), 479–484.PubMedCrossRef Gupta, M. A., Gupta, A. K., Kirkby, S., Schork, N. J., Weiner, H. K., Ellis, C. N., et al. (1989). Pruritus associated with nocturnal wakenings: Organic or psychogenic? Journal of the American Academy of Dermatology, 21(3 Pt 1), 479–484.PubMedCrossRef
27.
go back to reference Mucsi, I., Molnar, M. Z., Ambrus, C., Szeifert, L., Kovacs, A. Z., Zoller, R., et al. (2005). Restless legs syndrome, insomnia and quality of life in patients on maintenance dialysis. Nephrology, Dialysis, Transplantation, 20(3), 571–577.PubMedCrossRef Mucsi, I., Molnar, M. Z., Ambrus, C., Szeifert, L., Kovacs, A. Z., Zoller, R., et al. (2005). Restless legs syndrome, insomnia and quality of life in patients on maintenance dialysis. Nephrology, Dialysis, Transplantation, 20(3), 571–577.PubMedCrossRef
28.
go back to reference Tuncel, D., Orhan, F. O., Sayarlioglu, H., Isik, I. O., Utku, U., & Dinc, A. (2010). Restless legs syndrome in hemodialysis patients: Association with depression and quality of life. Sleep Breath. doi:10.1007/s11325-010-0382-z Tuncel, D., Orhan, F. O., Sayarlioglu, H., Isik, I. O., Utku, U., & Dinc, A. (2010). Restless legs syndrome in hemodialysis patients: Association with depression and quality of life. Sleep Breath. doi:10.​1007/​s11325-010-0382-z
29.
go back to reference Vessal, G., Sagheb, M. M., Shilian, S., Jafari, P., & Samani, S. M. (2009). Effect of oral cromolyn sodium on CKD-associated pruritus and serum tryptase level: A double-blind placebo-controlled study. Nephrol Dial Transplant. Vessal, G., Sagheb, M. M., Shilian, S., Jafari, P., & Samani, S. M. (2009). Effect of oral cromolyn sodium on CKD-associated pruritus and serum tryptase level: A double-blind placebo-controlled study. Nephrol Dial Transplant.
30.
go back to reference Kumagai, H., Ebata, T., Takamori, K., Muramatsu, T., Nakamoto, H., & Suzuki, H. (2010). Effect of a novel kappa-receptor agonist, nalfurafine hydrochloride, on severe itch in 337 haemodialysis patients: A Phase III, randomized, double-blind, placebo-controlled study. Nephrology, Dialysis, Transplantation, 25(4), 1251–1257.PubMedCrossRef Kumagai, H., Ebata, T., Takamori, K., Muramatsu, T., Nakamoto, H., & Suzuki, H. (2010). Effect of a novel kappa-receptor agonist, nalfurafine hydrochloride, on severe itch in 337 haemodialysis patients: A Phase III, randomized, double-blind, placebo-controlled study. Nephrology, Dialysis, Transplantation, 25(4), 1251–1257.PubMedCrossRef
Metagegevens
Titel
Assessment of the psychological burden associated with pruritus in hemodialysis patients using the kidney disease quality of life short form
Auteurs
Gildete Barreto Lopes
Fernanda Conceição Pereira Nogueira
Milena Reis de Souza
Maria Auxiliadora Penalva
Josete Leão de Amorim
Ronald L. Pisoni
Bruce M. Robinson
Antonio Alberto Lopes
Publicatiedatum
01-05-2012
Uitgeverij
Springer Netherlands
Gepubliceerd in
Quality of Life Research / Uitgave 4/2012
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-011-9964-x