ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2019 and some content may be unavailable. To unlock all content for 2019, please visit the archives.

Abstract: TH-PO244

Pruritus and Patient-Reported Outcomes (PROs): Associations Between the Skindex-10 and PROs in Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Karaboyas, Angelo, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Pisoni, Ronald L., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Rayner, Hugh C., Heart of England NHS Foundation Trust, Birmingham, WEST MIDLANDS, United Kingdom
  • Guebre Egziabher, Fitsum, Hospital Albert Michallon, La Tronche, France
  • Csomor, Philipp, Vifor Fresenius Medical Care Renal Pharma Ltd., Glattbrugg, Switzerland
  • Schaufler, Thilo, Vifor Pharma Management Ltd., Glattbrugg, Switzerland
  • Wen, Warren, Cara Therapeutics, Stamford, Connecticut, United States
  • Menzaghi, Frederique, Cara Therapeutics, Inc., Stamford, Connecticut, United States
  • Hasegawa, Takeshi, Showa University, Yokohama, KANAGAWA, Japan
  • Chen, Yuqing, Peking University First Hospital, Beijing, China
  • Al-Ghamdi, Saeed, King Faisal Speciialist Hospital & Research Center-Jeddah, Jeddah, Saudi Arabia
  • Sukul, Nidhi, University of Michigan, Ann Arbor, Michigan, United States
Background

Chronic kidney disease-associated Pruritus (CKD-aP) is a prevalent and distressing symptom in hemodialysis (HD) patients that affects Health Related Quality of Life (HR-QoL), but remains poorly characterized.

Methods

We analyzed 5418 HD patients from 17 countries in phase 5 (2013) of the Dialysis Outcomes and Practice Patterns Study (DOPPS) who self-reported being bothered by itchy skin (yes/no). “No” responses were assigned a Skindex-10 (SK-10) score of 0. Patients responding “Yes” then answered 10 questions about the frequency (0-6 scale) they were distressed by various aspects of CKD-aP. We investigated the association between SK-10 score (0-60 range; higher = more bothered) and 4 outcomes: (1) Physical and (2) Mental Component Summary (PCS; MCS) scores from the SF-12 (higher score = better HR-QoL) using linear mixed models; (3) Center for Epidemiologic Studies-Depression (CES-D) score ≥10 (indicative of depressive symptoms) and (4) Poor sleep quality (≥3 nights/week of restless sleep), both using modified Poisson regression.

Results

Mean SK-10 score was 12.2 overall and 27.4 among those affected by CKD-aP (Yes responders); 45% of patients had SK-10 score >0, including 17% with 1-20, 19% with 21-40, and 9% with 41-60. In adjusted models, lower PCS and MCS scores, poorer sleep quality, and greater likelihood of CES-D ≥10 were observed with increasingly higher SK-10 scores (Figure). SK-10 was highly correlated (r=0.71) with a separate summary question about the extent patients were bothered by itchy skin in the past 4 weeks.

Conclusion

Pruritus severity, reflected by the SK-10, was clearly and monotonically associated with other PROs including physical and mental HR-QoL, depression, and sleep quality, further emphasizing the importance of identifying and treating CKD-aP. Given its strong correlation with the SK-10 score, the single summary question could make routine assessment of pruritus in HD patients more concise and efficient.

Funding

  • NIDDK Support –