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Kidney Week

Abstract: TH-PO1139

The Association Between Pruritus Severity and Mental Health-Related Quality of Life in over 80,000 Hemodialysis Patients

Session Information

  • Late-Breaking Posters
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Ficociello, Linda, Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
  • Desai, Tejas, Vifor Pharma Management Ltd, Glattbrugg, Zurich, Switzerland
  • Oliveira, Juliana H., Vifor Pharma Management Ltd, Glattbrugg, Zurich, Switzerland
  • Arens, Hans-Juergen, Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
  • Lasky, Rachel A., Vifor Pharma Management Ltd, Glattbrugg, Zurich, Switzerland
  • Anger, Michael S., Fresenius Medical Care Holdings Inc, Waltham, Massachusetts, United States
Background

Chronic kidney disease associated pruritus is common in hemodialysis (HD) patients and can impact quality of life (QoL). The Kidney Disease Quality of Life 36-Item Short Form Health Survey (KDQOL-36) captures patient reported health-related QoL and symptoms including pruritus (q 20) and mental health-related factors, such as depression (q 11) and anxiety (q 9). Another tool, Patient Health Questionnaire-2 (PHQ2), measures depressive symptoms. The goal of this cross-sectional, retrospective database analysis was to evaluate the association of depression and anxiety scores with varying levels of pruritus.

Methods

Fresenius Kidney Care, adult, in-center HD patients with SF-36 measured between 1/1/21 and 2/28/23 are eligible. Patients answering that they are burdened by at least “moderate” pruritus were included in the analysis. A random sample of patients from the “not at all” and “somewhat” bothered respondents was selected. This stratified sampling technique was used to guarantee patients from each itch severity group will be adequately represented in the study population. ANOVA and logistic regression were used to test the mean scores (0=highest burden to 100=lowest burden) or odds ratios across itch levels. PHQ2 scores > 3 have been a screening tool for depression and were used to dichotomize scores into depression present or absent.

Results

81,310 patients had completed SF-36, of which 77,978 (96%) also had PHQ2 completed within 30 days. Burden of anxiety (p<0.0001) and depression (p<0.0001) symptoms was more likely as itch intensity increased. Mean scores for anxiety and depression differed by pruritis severity. Next, using PHQ2 scores of > 3 to define depression, we found a stepwise increased risk of depression with each increase in pruritus intensity score (Figure 1). Patients who were extremely bothered by pruritus had 6 times the odds of having depression when compared to those patients “not at all bothered” by pruritus (p<0.001).

Conclusion

These data have shown a strong association of pruritus with depression and anxiety.

Funding

  • Commercial Support – CSL Vifor