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Abstract: PO0796

Shortened or Skipped Hemodialysis Sessions Attributed to Uremic Pruritus: A National Kidney Foundation Patient Survey

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Gomez, Johnson Lim, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Vassalotti, Joseph A., Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Torres, Gail, National Kidney Foundation, New York, New York, United States
  • Singleton-Driscoll, Linda, Chleire Consulting, Inc, Richmond, Virginia, United States
Background

Hemodialysis (HD) patients are at risk for uremic pruritus, a common and bothersome condition that may make it difficult for patients to complete the prescribed HD sessions. The purpose of this study is to investigate the extent to which pruritus contributes to patients shortening or skipping HD sessions. Studies have demonstrated that shortening and skipping HD treatments increases mortality risk.

Methods

An online survey of adults (18 years and older), across the U.S. from November 11-27, 2020, was conducted using two links posted on the National Kidney Foundation Facebook page. A $5 electronic Amazon gift card incentive was offered to the first 300 respondents with a valid email address.

Results

There were 692 participants among 2604 initial respondents, after excluding 1,252 for partial survey completion, 516 for not having kidney disease and 144 for kidney disease without HD treatment. Demographics and clinical characteristics include mean age 38.5 years ±11.8, 46.8% under 35 years, 45.5% females, 15% Black or African American, 9% Hispanic, 9% American Indian, 3% Asian, 74.7% employed or attending school, 45.3% with 1-5 years HD vintage, 81% treated with center HD and 19% treated with home HD. This population is younger and enriched for home HD and employment compared to 2018 results from the USRDS 2020 Annual Data Report, with only 11% HD age < 45 years, 2% treated with home HD and low employment prevalence.

Pruritus was common with 64.0% (428/669) self-reporting itch that is at least somewhat intense on a Likert scale, including 25.7% (172/669) of patients reporting itch as very or extremely intense. Shortening or skipping an HD session because of pruritus was reported at least some of the time by 55.6% (334/601) and 50.4% (303/601) of participants, respectively. Patients reporting the itch as very or extremely intense were more likely to skip or miss HD treatments. Among the members of the HD care team, nephrologists 43.2% (299/692) were the most likely professional to be identified by patients to talk with about itchy skin.

Conclusion

This survey cohort of HD patients showed pruritus leading to skipped or shortened HD sessions occurred in about half of the patients. The results support uremic pruritus as a significant cause of skipped or shortened HD sessions for the dialysis care team to consider.

Funding

  • Commercial Support