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Abstract: TH-PO985

Pruritus and Labor Force Participation in Dialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Desai, Tejas, CSL Vifor, Redwood City, California, United States
  • Kammerer, Jennifer A., CSL Vifor, Redwood City, California, United States
  • Thompson, Jeffrey, Cerner Enviza, North Kansas City, Missouri, United States
  • Oliveira, Juliana H., CSL Vifor, Redwood City, California, United States
  • Johansen, Kirsten L., Hennepin Healthcare, Minneapolis, Minnesota, United States

Nearly one-quarter of in-center hemodialysis (HD) patients are in the labor force at HD initiation. Fewer remain employed as HD vintage increases. Involuntary exit from labor participation can be a devastating sequela of end-stage kidney failure for patients and society. The PRImE ITCH study assessed the association between pruritus (itch) and unintentional/undesired productivity losses.


The PRImE ITCH study surveyed members of the American Association of Kidney Patients or Cerner Enviza patient panel to assess itch burden. Adult HD patients reporting itch in the past 28 days were stratified by Worst Itch Numerical Rating Scale (WINRS) severity. The Work Productivity and Activity Impairment questionnaire (WPAI; 0-100% scale) was completed by currently employed HD patients to assess labor productivity changes attributed to itch. Higher WPAI scores indicate greater work impairment and lower productivity. Absenteeism is defined as work time missed. Presenteeism is defined as working with reduced effectiveness.


Of 369 patients, 354 (96%) completed the WINRS. Of 354 patients, 145 (41%) completed the WPAI and were employed with 75% reporting an annual salary of <$100K. Their mean ± SD age was 36.7 ± 11.8 years, and 87% reported moderate or severe itch. Patients with severe itch had more work impairment (mean difference [95% CI] 23.9% [13.3-34.5%]) than those with mild symptoms, and more absenteeism and presenteeism than those with mild (19.2% and 40.4%, respectively) or moderate itch (15.9% and 18.0%, respectively). Patients with moderate itch had more work impairment (19.1% [8.7-29.4%]) and employment presenteeism (22.4% [10.6-34.1%]) than those with mild itch (Figure).


Results of the PRImE ITCH study show that increasing severity of itch is associated with reduced labor force participation among prevalent HD patients. Further study is needed to confirm these findings and determine if itch treatment can mitigate loss of labor productivity in employed US HD patients.


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