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Abstract: FR-PO421

The Impact of Intradialytic Cycling on the Symptom of CKD-Associated Pruritus

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Joshi, Namrata, University of Leicester College of Life Sciences, Leicester, United Kingdom
  • Burton, James, University of Leicester College of Life Sciences, Leicester, United Kingdom
  • Jennings, Angus C., University of Leicester College of Life Sciences, Leicester, United Kingdom
  • Abell, Lucy O., University of Leicester College of Life Sciences, Leicester, United Kingdom
  • Billany, Roseanne, University of Leicester College of Life Sciences, Leicester, United Kingdom
  • March, Daniel Scott, University of Leicester College of Life Sciences, Leicester, United Kingdom
  • Graham-Brown, Matthew, University of Leicester College of Life Sciences, Leicester, United Kingdom
  • Hull, Katherine Leigh, University of Leicester College of Life Sciences, Leicester, United Kingdom
Background

CKD associated pruritus (CKD-aP) is an extremely common symptom amongst haemodialysis (HD) patients. The pathophysiology of CKD-aP is complex and multifactorial; chronic inflammation has been hypothesised as a key contributor. Individuals on maintenance HD experience high levels of chronic inflammation. Previous research has demonstrated that regular intradialytic exercise (IDE) may have an anti-inflammatory effect. This suggests that IDE may reduce levels of CKD-aP in the HD population. This work aimed to ascertain the effect of 6-months of regular IDE on CKD-aP.

Methods

Post hoc analyses of data from the CYCLE-HD (ISRCTN11299707) study. 130 HD patients were randomised to standard care or IDE for 6-months. Data regarding CKD-aP were available from 118 participants who completed the Palliative care Outcome Scale-Symptoms (POS-S) Renal at baseline and 6-months. Statistical testing included proportional odds logistic regression adjusting for baseline itch, age, sex, dialysis vintage and baseline BMI.

Results

At baseline CKD-aP was present in 68.1% of participants (control=66.1%, IDE=70.0%). CKD-aP was classified as mild (27.1%, n=32), moderate (24.6%, n=29), severe (11%, n=13), and overwhelming (3.4%, n=5). There was no statistically significant impact of group assignment on 6-month itchiness; however, the odds of a one category increase in CKD-aP severity was lower (13%) in participants assigned to the IDE group after 6-months (OR=0.87, 95% CI: 0.42, 1.81; p=0.7163). Alluvial plots (Figure) of baseline vs 6-month CKD-aP score categorised by group further demonstrated that group assignment had no marked impact on CKD-aP severity at 6-months.

Conclusion

These results demonstrate that CKD-aP is common in the HD population and 6-months of IDE did not impact on the prevalence or severity. As such, pharmacotherapy should be considered as a primary treatment option.

Alluvial plots demonstrating group assignment did not significantly impact CKD-aP severity at 6-months

Funding

  • Other NIH Support