Pruritus and Patient Reported Outcomes in Non-Dialysis CKD.

Sukul, Nidhi and Speyer, Elodie and Tu, Charlotte and Bieber, Brian A and Li, Yun and Lopes, Antonio A and Asahi, Koichi and Mariani, Laura and Laville, Maurice and Rayner, Hugh C and Stengel, Bénédicte and Robinson, Bruce M and Pisoni, Ronald L (2019) Pruritus and Patient Reported Outcomes in Non-Dialysis CKD. Clinical journal of the American Society of Nephrology : CJASN, 14 (5). pp. 673-681. ISSN 1555-905X. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: https://cjasn.asnjournals.org/content/14/5/673.lon...

Abstract

BACKGROUND AND OBJECTIVES

Among patients on hemodialysis, pruritus has been associated with poorer mental and physical quality of life, sleep quality, depression, and mortality. We evaluated patients with nondialysis CKD to describe the prevalence of pruritus, identify associated factors, and investigate associations with patient-reported outcomes.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

Using cross-sectional data from patient questionnaires in the CKD Outcomes and Practice Patterns Study (CKDopps), we asked patients with CKD stages 3-5 (nondialysis) from the United States, Brazil, and France to identify how much they were bothered by pruritus. Response options ranged from "not at all" to "extremely." Log-Poisson regression, yielding prevalence ratios, was used to evaluate associations of moderate-to-extreme pruritus with patient characteristics, CKD stage, self-reported depression symptoms, and restless sleep. Mixed linear regression was used to examine associations between pruritus and physical and mental component summary scores, with lower scores indicating poorer quality of life.

RESULTS

Of the 5658 CKDopps patients enrolled in the United States, Brazil, and France, 3780 (67%) answered the pruritus question. The prevalence of moderate-to-extreme pruritus was 24%, and more likely in older patients, women, and those with stage 5 CKD, lung disease, diabetes, and physician-diagnosed depression. In adjusted models, patients with moderate pruritus had physical and mental component summary scores 3.5 (95% confidence interval [95% CI], -4.6 to -2.3) and 2.3 (95% CI, -3.2 to -1.5) points lower, respectively, than patients without pruritus, and they also had a higher adjusted prevalence of patient-reported depression (prevalence ratio, 1.83; 95% CI, 1.58 to 2.11) and restless sleep (prevalence ratio, 1.69; 95% CI, 1.49 to 1.91) compared with patients without pruritus. These patient-reported outcomes were progressively worse with increasing severity of pruritus.

CONCLUSIONS

Our findings demonstrate high prevalence of pruritus in nondialysis CKD, as well as strong associations of pruritus with poor health-related quality of life, self-reported depression symptoms, and self-reported poor sleep.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WJ Urogenital system. Urology
Divisions: Emergency Services > Renal
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Depositing User: Mrs Semanti Chakraborty
Date Deposited: 24 Jun 2019 15:35
Last Modified: 24 Jun 2019 15:35
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/2182

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