ITCHING - Uremic Pruritus Impairs Key Aspects of Quality of Life

Uremic Pruritus Impairs Key Aspects of Quality of Life in Hemodialysis Patients: Presented at ASN

By Maggie Schwarz

PHILADELPHIA -- November 8, 2008 -- Uremic pruritus adversely affects important aspects of of life such as mood, sleep, social functioning, and even the intensity of itching. Small reductions in these may improve patients' quality of life, researchers noted at Renal Week 2008, the American Society of Nephrology (ASN) annual meeting.

According to the Dialysis Outcomes and Practice Patterns Study (DOPPS II), 40% of hemodialysis patients suffer from moderate to extreme pruritus. Yet the condition has not been well studied, noted Michael Germain, MD, Tufts University, Boston and Baystate Medical Center, Springfield, Massachusetts, speaking here at a poster session on November 6.

Dr. Germain and his team of investigators performed a prospective, multicenter, two-part study termed the Itch National Registry. Subjects were recruited from 13 US dialysis units using completed surveys, including visual analogue scale (VAS) scores evaluating pruritus intensity. Medical history, medication, dialysis, and laboratory data were obtained from patients' charts. Other health-related quality-of-life measures were the Skindex-10, Brief Itch Inventory, Beck Depression Index, and Medical Outcomes Survey Sleep Questionnaire.

Participants were adults on chronic hemodialysis at least 3 times weekly who had mild, moderate, or severe pruritus. The majority of participants were African American, consistent with the geographic distribution of the study sites, most of which were in the Southeast. Subjects had had end-stage renal disease for a mean of approximately 4 years.

Despite relatively well controlled calcium, phosphorus, and parathyroid hormone and a mean dialysis dose of 1.69 Kt/V, itching intensity was high.

Incremental increases in VAS scores of itching intensity were associated with decrements in health-related quality of life. There were significant associations across multiple instruments between itching intensity and multiple measures of quality of life, including mood, sleep, and social functioning.

"The Itch National Registry is the first documentation of these effects on quality of life," Dr. Germain noted.

Funding for this study was provided by Acologix, Inc.

[Presentation title: Correlation Between Uremic Pruritus Intensity and Quality of Life: A Report from the ITCH National Registry. Abstract TH-PO798]

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