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Kidney Week

Abstract: FR-PO424

Assessing the Quality of Life in Hemodialysis Patients with CKD-Associated Pruritus in Clinical Practice

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kalantar-Zadeh, Kamyar, Harbor-UCLA Medical Center, Torrance, California, United States
  • Schaufler, Thilo, CSL Vifor, Glattbrugg, Switzerland
  • Latus, Joerg, Robert-Bosch-Krankenhaus GmbH, Stuttgart, Baden-Württemberg, Germany
  • Ruessmann, Despina, CSL Vifor, Glattbrugg, Switzerland
  • Morin, Isabelle, CSL Vifor, Glattbrugg, Switzerland
  • Menzaghi, Frederique, Cara Therapeutics Inc, Stamford, Connecticut, United States
  • Mccafferty, Kieran, Barts Health NHS Trust, London, London, United Kingdom
Background

The detrimental impact of chronic kidney disease-associated pruritus (CKD-aP) on the quality of life (QoL) of hemodialysis (HD) patients has been well established in epidemiologic studies. However, diagnosis of CKD-aP and its consequences is not yet routine dialysis practice and no standard instrument is established.

Methods

KALM-1, KALM-2 and 3105 are phase-3 clinical studies evaluating safety and efficacy of difelikefalin in adult HD patients with moderate to severe CKD-aP. Itch intensity at baseline was assessed with the weekly average of the Worst Itching Intensity Numerical Rating Scale (WI-NRS, range 0 [no itch] to 10 [worst itch imaginable]) and defined as moderate (KALM-1: >4 to <7; KALM-2 and 3105 ≥5 to <7; N=448) or severe (≥7; N=625). We set out to compare the association between itch severity and QoL domains in this cohort. Itch-related QoL at baseline was assessed with Skindex-10 (Sk-10; range 0 to 60) and 5-D Itch (5-D; range 5 to 25) scales with higher values indicating worse impact on itch-related QoL.

Results

Patients experiencing moderate / severe itch reported scores of 15.0 / 18.2 (5-D) and 29.3 / 39.7 (Sk-10), equivalent to 60.1% / 72.8% and 48.8% / 66.2% of the maximum for the corresponding scale respectively. Individual domains show a similar pattern. 5-D domains are relatively evenly balanced with Duration being an outlier at the lower end. Sk-10 was most influenced by the disease domain (Figure).

Conclusion

Either instrument can be useful in clinical practice: Sk-10 to complement WI-NRS with a differentiated measure of QoL and 5-D as a standalone option by combining itch intensity and impact on daily activities.

Funding

  • Commercial Support – CSL Vifor