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03-06-2023

Chronic kidney disease-associated pruritus (CKD-aP) is associated with worse quality of life and increased healthcare utilization among dialysis patients

Auteurs: Jasmine Ion Titapiccolo, Caterina Lonati, Berit Goethel-Paal, Abraham Rincon Bello, Francesco Bellocchio, Alessandro Pizzo, Maxime Theodose, Maria Eva Baro Salvador, Michaela Schofield, Mario Cioffi, Kolitha Basnayake, Chis Chisholm, Suzanne Mitrovic, Marjelka Trkulja, Hans-Juergen Arens, Stefano Stuard, Luca Neri

Gepubliceerd in: Quality of Life Research | Uitgave 10/2023

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Abstract

Purpose

Chronic pruritus significantly impairs hemodialysis patients’ health status and quality of life (QOL) and it is associated with higher mortality rate, more frequent hospitalizations, poorer dialysis and medication adherence, and deteriorated mental status. However, pruritus is still underestimated, underdiagnosed, and undertreated in the real-life clinical scenario. We investigated prevalence, clinical characteristics, clinical correlates, severity as well as physical and psychological burden of chronic pruritus among adult hemodialysis patients in a large international real-world cohort.

Methods

We conducted a retrospective cross-sectional study of patients registered in 152 Fresenius Medical Care (FMC) NephroCare clinics located in Italy, France, Ireland, United Kingdom, and Spain. Demographic and medical data were retrieved from the EuCliD® (European Clinical) database, while information on pruritus and QoL were abstracted from KDQOL™-36 and 5-D Itch questionnaire scores.

Results

A total of 6221 patients were included, of which 1238 were from France, 163 Ireland, 1469 Italy, 2633 Spain, and 718 UK. The prevalence of mild-to-severe pruritus was 47.9% (n = 2977 patients). Increased pruritus severity was associated with increased use of antidepressants, antihistamines, and gabapentin. Patients with severe pruritus more likely suffered from diabetes, more frequently missed dialysis sessions, and underwent more hospitalizations due to infections. Both mental and physical QOL scores were progressively lower as the severity of pruritus increased; this association was robust to adjustment for potential confounders.

Conclusion

This international real-world analysis confirms that chronic pruritus is a highly prevalent condition among dialysis patients and highlights its considerable burden on several dimensions of patients’ life.
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Metagegevens
Titel
Chronic kidney disease-associated pruritus (CKD-aP) is associated with worse quality of life and increased healthcare utilization among dialysis patients
Auteurs
Jasmine Ion Titapiccolo
Caterina Lonati
Berit Goethel-Paal
Abraham Rincon Bello
Francesco Bellocchio
Alessandro Pizzo
Maxime Theodose
Maria Eva Baro Salvador
Michaela Schofield
Mario Cioffi
Kolitha Basnayake
Chis Chisholm
Suzanne Mitrovic
Marjelka Trkulja
Hans-Juergen Arens
Stefano Stuard
Luca Neri
Publicatiedatum
03-06-2023
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 10/2023
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-023-03438-6

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