Prognostic importance and determinants of uremic pruritus in patients receiving peritoneal dialysis: A prospective cohort study

Hon Yen Wu, Jenq Wen Huang, Wan Chuan Tsai, Yu Sen Peng, Hung Yuan Chen, Ju Yeh Yang, Shih Ping Hsu, Mei Fen Pai, Mei Ju Ko, Kuan Yu Hung, Hsien Ching Chiu

Research output: Contribution to journalReview articlepeer-review

25 Citations (Scopus)

Abstract

Background Uremic pruritus is a common and frustrating symptom among patients receiving peritoneal dialysis (PD). This study aimed to examine the prognostic importance of uremic pruritus and to identify the determinants for higher pruritus intensity in PD patients. Methods We conducted a prospective cohort study of patients receiving maintenance PD. A visual analogue scale (VAS) score was used to measure the intensity of uremic pruritus. The composite endpoint of PD technique failure or all-cause death was assessed using a multivariable Cox proportional hazards model. The determinants for the VAS score of uremic pruritus was assessed using a multivariable linear regression model. Results Among the 85 PD patients, 24 (28%) had uremic pruritus. During a median follow-up of 28.0 months, 12 patients experienced technique failure, and 7 died. We found that a higher VAS score of pruritus intensity was an independent risk factor for technique failure or death (hazard ratio, 1.64; 95% confidence interval, 1.18 to 2.28; P = 0.003) after adjusting for a variety of confounding factors. We also found that a weekly total Kt/V of less than 1.88, a longer duration of dialysis, a higher dietary protein intake, and higher blood levels of intact parathyroid hormone and high-sensitivity C-reactive protein were independent determinants of higher VAS scores of pruritus intensity. Conclusions Our results show that uremic pruritus is an independent risk factor of technique failure and death in patients receiving PD. We also found that a weekly total Kt/V < 1.88 is associated with higher intensity of uremic pruritus in PD patients.

Original languageEnglish
Article numbere0203474
JournalPLoS ONE
Volume13
Issue number9
DOIs
Publication statusPublished - Sept 2018
Externally publishedYes

ASJC Scopus subject areas

  • General

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