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Longitudinal Trajectories of CKD-Associated Pruritus
Marc G Vervloet1, Charlotte Tu2, Sammantha Fuller2
1Radboud University Medical Center, Nijmegen, The Netherlands.
Kidney International Reports
|January 16, 2026
Summary
Chronic kidney disease (CKD)-associated pruritus (CKD-aP) affects over half of hemodialysis patients, worsening fatigue and sleep. Early detection and management are crucial for improving patient well-being.
Area of Science:
- Nephrology
- Dermatology
- Psychiatry
Background:
- Chronic kidney disease (CKD)-associated pruritus (CKD-aP) is a prevalent and distressing symptom in hemodialysis (HD) patients.
- It significantly impacts patient-reported outcomes (PROs), including sleep and mental health.
- The long-term evolution, incidence, and predictors of CKD-aP remain poorly understood.
Purpose of the Study:
- To determine the cumulative incidence of new-onset CKD-aP in HD patients.
- To identify key predictors of moderate-to-severe CKD-aP.
- To assess the association between CKD-aP severity and PROs.
Main Methods:
- A prospective, multicenter cohort study followed 747 incident and prevalent HD patients across 6 European countries for 18 months.
- Electronic PRO (ePRO) surveys assessed pruritus, fatigue, sleep, depression, and general health every 3 months.
- Statistical analyses included Sankey diagrams, Spearman's correlations, Cox regression, and linear regression.
Main Results:
- The 18-month cumulative incidence of moderate-to-severe pruritus was 52%.
- Sociodemographic and clinical factors were weak predictors of incident pruritus.
- Patients with incident pruritus reported significantly higher fatigue and poorer sleep quality compared to those without pruritus.
Conclusions:
- CKD-aP is a common, fluctuating symptom in HD patients.
- CKD-aP is strongly associated with increased fatigue and decreased sleep quality.
- Ongoing monitoring and targeted interventions are essential for managing CKD-aP and improving patient quality of life.
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