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Pruritus and Patient Reported Outcomes in Non-Dialysis CKD.

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Pruritus, or itching, affects 24% of patients with chronic kidney disease (CKD) not on dialysis. This condition is linked to worse quality of life, depression, and sleep disturbances in CKD patients.

Keywords:
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Area of Science:

  • Nephrology
  • Dermatology
  • Psychiatry

Background:

  • Pruritus is a common and distressing symptom in patients with chronic kidney disease (CKD).
  • While known to impact hemodialysis patients, its prevalence and effects in nondialysis CKD populations require further investigation.
  • Previous studies highlight associations between pruritus and adverse outcomes in hemodialysis patients, including impaired quality of life and increased mortality.

Purpose of the Study:

  • To determine the prevalence of pruritus in patients with nondialysis CKD stages 3-5.
  • To identify patient characteristics and clinical factors associated with pruritus in this population.
  • To investigate the relationship between pruritus and patient-reported outcomes such as quality of life, depression, and sleep quality.

Main Methods:

  • Cross-sectional study utilizing patient questionnaires from the CKD Outcomes and Practice Patterns Study (CKDopps) in the US, Brazil, and France.
  • Patients with CKD stages 3-5 (nondialysis) reported the severity of pruritus they experienced.
  • Log-Poisson and mixed linear regression models were employed to analyze associations between pruritus and patient characteristics, CKD stage, depression, sleep quality, and quality of life scores.

Main Results:

  • The prevalence of moderate-to-extreme pruritus was 24% among 3780 surveyed nondialysis CKD patients.
  • Pruritus was more common in older patients, women, and those with stage 5 CKD, lung disease, diabetes, or physician-diagnosed depression.
  • Patients with moderate pruritus reported significantly lower physical and mental quality of life scores, and higher prevalence of depression and restless sleep compared to those without pruritus.

Conclusions:

  • Pruritus is highly prevalent in patients with nondialysis CKD.
  • A significant association exists between pruritus and diminished health-related quality of life, increased symptoms of depression, and poor sleep quality.
  • These findings underscore the substantial negative impact of pruritus on the well-being of individuals with CKD.