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Abstract: SA-PO285

CKD-Associated Pruritus (CKD-aP) in Hemodialysis (HD) Patients: Comparison of Instruments Used to Measure Self-Reported Itch Severity

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Karaboyas, Angelo, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Tu, Charlotte, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Sukul, Nidhi, University of Michigan Department of Internal Medicine, Ann Arbor, Michigan, United States
  • Asgari, Elham, Guy's and St Thomas' NHS Foundation Trust, London, London, United Kingdom
  • Guebre Egziabher, Fitsum, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes , France
  • Walpen, Sebastian, Vifor Pharma Ltd, Glattbrugg, Zurich, Switzerland
  • Schaufler, Thilo, Vifor Pharma Ltd, Glattbrugg, Zurich, Switzerland
  • Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Pisoni, Ronald L., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

The associations between self-reported CKD-aP and patient reported outcomes (PROs) have been well reported, but have generally been limited to a single baseline CKD-aP assessment. Collection of multiple CKD-aP instruments allows for evaluation of different domains and approaches to measure CKD-aP burden, and may further help tailor data capture for future research or clinical care.


An electronic PRO (ePRO) survey was distributed to HD patients enrolled in the Dialysis Outcomes and Practice Patterns Study (DOPPS) in 2021-2022, and included 4 CKD-aP instruments: (1) a single question from the KDQOL-36 about the extent patients were bothered by itchy skin; (2) the 5-D itch, which assesses five dimensions of itch; and questions about the (3) worst itch [WI-NRS] and (4) average itch [AI-NRS] experienced. We calculated the Spearman correlation between each instrument, and stratified mean 5-D itch and NRS scores by response to the single KDQOL-36 question.


Data collection is ongoing; 250 patients from 24 HD facilities in 4 countries (France, Germany, Spain, UK) have thus far completed the baseline survey. Patients ‘not at all’ bothered by itchy skin (N=104; 41%) were not asked to complete other CKD-aP instruments. Among the remaining 146 patients, the KDQOL-36 response was correlated with the WI-NRS (0.49), AI-NRS (0.52), and 5-D itch (0.56) – more so with the degree (0.67) and duration (0.55) domains than the distribution (0.42), disability (0.32), and direction (0.21) domains. Across response levels (somewhat, moderately, very much, extremely) of the KDQOL-36 question, the respective mean scores of other CKD-aP instruments were 10.0, 11.7, 14.7, 20.8 for 5-D itch; 2.7, 3.7, 5.6, 8.3 for AI-NRS; and 3.0, 4.1, 6.1, 8.4 for WI-NRS.


Correlation between CKD-aP instruments was relatively high; differences can be partially attributed to the recall period for the KDQOL-36 (4 weeks) vs. the 5-D itch (2 weeks) and NRS (24 hours). Understanding the relationships between CKD-aP instruments will help us interpret and link findings across observational and randomized studies that use different approaches to measure CKD-aP.


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