A Clinical Study on Uremic Pruritus in Hemodialysis Patients

Sim, Hyun Soo; Seo, Jong Keun; Lee, Sook Kyung

Abstract

BACKGROUND
Uremic pruritus is a common disabling problem in patients with end-stage renal disease (ESRD). Not many studies have focused on evaluating the clinical characteristics of uremic pruritus.
OBJECTIVE
The aim of this study was to identify the prevalence and clinical characteristics of uremic pruritus in hemodialysis patients.
METHODS
A detailed questionnaire was used to evaluate the pruritus of 75 patients who were treated at the hemodialysis unit in Maryknoll Medical Center. We examined the relationship of the quality of dialysis and various factors and medical parameters with uremic pruritus.
RESULTS
Pruritus was a common symptom in the study population. Twenty two point seven percent of the patients had severe pruritus in the past, and 36% were affected by it at the time of the study. There was no correlation between the occurrence of pruritus and the demographic or medical parameters of the patients (gender, age, the cause of ESRD, the duration of ESRD and hemodialysis, previous treatment of ESRD, the dialysis efficacy as expressed by Kt/V, and the transfusion and laboratory parameters such as blood urea nitrogen, creatinine, calcium, phosphorus, parathyroid hormone and uric acid). Skin dryness was found in 14 (18.7%) patients. It was assessed as slightly dry skin in 9 (12.0%) patients and as rough skin in 5 (6.7%) patients. A significant relationship was demonstrated between the intensity of xerosis and the frequency of uremic pruritus (p=0.042). The intensity of xerosis was greater in the severe pruritic patients, but any statistically significant correlation was not found. The major factors found to exacerbate pruritus included sleep disturbance, heat, dry skin and dialysis. The major factors found to reduce pruritus included taking a shower or bath, sleeping, dialysis and physical activity.
CONCLUSION
There was a significant relationship between the intensity of xerosis and the frequency of uremic pruritus. A better understanding of the clinical characteristics of uremic pruritus will afford clinicians the necessary elementary tools to discover its origin and the possible effective treatments.