Tungs’ Medical Journal (Jan 2022)

Exploring factors associated with uremic pruritus

  • Chiu-Feng Wu,
  • Ya-Chu Hsiao,
  • Tzu-Pei Yeh,
  • Peir-Haur Hung,
  • Haiag-Chun Chen,
  • Ru-Yin Tsai,
  • Chen-Pi Li

DOI
https://doi.org/10.4103/ETMJ.TMJ-110005
Journal volume & issue
Vol. 16, no. 2
pp. 66 – 72

Abstract

Read online

Background: Uremic pruritus not only directly affects patients' health but also may reduce their quality of life. Few studies have examined the factors associated with pruritus disturbance among patients on hemodialysis. Objectives: This study aimed to compare the differences between patients on hemodialysis with and without uremic pruritus and explore the factors associated with uremic pruritus. Methods: A cross-sectional correlational design with convenience sampling was used in this study. Patients on hemodialysis in a regional hospital in southern Taiwan were recruited. A self-administered questionnaire was used, and some serum biochemistry data were collected from medical records. Research tools, including demographic characteristic form, pruritus visual analog scale (pruritus VAS), and the 5-D itch scale, were used. Multiple regression analysis was performed to explore the factors related to pruritus disturbance. Results: A total of 361 patients were included in this study. Most of the participants (n = 283, 78.4%) had pruritus. The two groups of patients with and without pruritus were different in diabetes status and creatinine and C-reactive protein (CRP) levels. The mean score of pruritus VAS was 5.0 in participants with pruritus, indicating that their pruritus was moderate. The level of pruritus disturbance was moderate to low (mean = 10.56), and “pruritus-affected sleep” possessed the highest score. Patients with higher CRP and pruritus gave higher scores for pruritus disturbance. Primary disease, heparin use, serum albumin, calcium, creatinine, blood urea nitrogen, CRP, and subjective pruritus severity could significantly predict disturbance from pruritus (R2 = 28.5%, P < 0.05). Maintaining serum biochemistry such as CRP within the normal range may reduce pruritus feeling. Conclusion: Patients' serum biochemistry is related to uremic pruritus. Health-care professionals should regularly assess patients' CRP and patients' self-evaluation of itching so that disturbances from pruritus can be detected earlier and the possible factors can be found and treated. These strategies may provide appropriate care and maintain the patients' quality of life.

Keywords