Chronic Kidney Disease-Associated Pruritus Severity and Treatment Experiences in Patients Receiving Dialysis

Chronic Kidney Disease-associated Pruritus is a chronic itching condition experienced by patients during and between dialysis sessions. The individualised nature of the condition makes prevalence and severity difficult to measure.

The study aimed to identify the prevalence of Chronic Kidney Disease-associated Pruritus amongst patients receiving dialysis in Ireland, characterise symptom burden, severity, and frequency, factors associated with worsening symptoms, and to examine patient experiences of itching.

A quantitative study with a qualitative free-text element was employed.

689 patients undergoing dialysis completed a national survey.

Patients undergoing haemodialysis and peritoneal dialysis completed the 5-D itch scale and a qualitative assessment of itching experiences. Regression analyses examined associations between domains of the 5-D itch scale, patient clinical characteristics and the occurrence of moderate-severe itching. Content analysis was used to report qualitative findings.

Sixty-two percent (85% haemodialysis; 15% peritoneal dialysis) experienced Chronic Kidney Disease-associated Pruritus; 66% reported moderate-severe itching, with body/trunk region most affected (73%); however, the scalp/face region was most associated with moderate-severe itching (OR = 2.08, 95% CI 1.11-3.870). Four themes were identified: (1) the physical impact of Chronic Kidney Disease-associated Pruritus; (2) the psychological burden of itching; (3) variability in treatment success; (4) itch resolving over time.

Two-thirds of Irish patients experience moderate-severe Chronic Kidney Disease-associated Pruritus; a prevalence rate higher than international estimates. This condition is psychologically distressing - impacting sleep, overall quality of life, and risk of infection. Patients require improved clinical attention and greater pratitioner education on management of this condition.