of HD patients in
the U.S. reported that
they
suffered from CKD-aP†
of HD patients
in
the U.S. were
moderately
to extremely
bothered by itch
CKD-aP=chronic kidney disease–associated pruritus; CKD=chronic kidney disease; HD=hemodialysis.
*Phases 4–6 of DOPPS (a prospective cohort study) included 34,694 HD patients in 21 countries from 2009–2018; 23,264 patients were eligible for analysis of the primary outcome. The primary clinical outcome was time to all-cause mortality; dialysis-related outcomes included withdrawal from dialysis and missed HD sessions; patient-reported outcomes included measure of health-related quality of life, depression, and sleep quality.
†Figure calculated based on total patients reporting being somewhat to extremely bothered by itching.
Watch this video featuring Dr. Stephen Fishbane that discusses the prevalence of CKD-aP in patients on
hemodialysis, as well as how to identify and assess the severity of CKD-aP in these patients.
This is an actual treating physician who was compensated for his time and consents to this use. Nothing in this video or website constitutes medical advice or treatment guidance.
Stephen Fishbane, MD
Nephrologist, Great Neck, NY
Member, ASN, NKF, RPA
of medical directors
underestimated the
prevalence of CKD-aP
in their facilities2
of U.S. patients who were
nearly
always or always
bothered by
itching did not
report it to any
healthcare
provider2
- Severity of patient-reported itch may vary over time—it may be intermittent or persistent, and may occur anytime in relation to dialysis—before, during, or after3
- When CKD-aP is generalized, it is often symmetrical—however, when it is localized, it often occurs on the face, back, and shunt arm only3
- Extreme hot or cold, stress, physical activity, and showering have been reported by patients to worsen CKD-aP4
- CKD-aP may occur without any skin manifestations, can coexist with xerosis, and can occur with superimposed complications of itching, including crusts and ulcerations3
Because this is a common condition in hemodialysis patients,
any sign of itching may be related to CKD-aP3
CKD-aP=chronic kidney disease–associated pruritus.
*Phases 1–5 of DOPPS (a prospective cohort study) included 51,062 HD patients in 21 countries from 1996–2015; 35,452 patients answered the question regarding how bothered they were by itchy skin in a questionnaire and were included in this analysis.
CKD patients undergoing hemodialysis have many challenges going on in their lives.
These can be exacerbated by CKD-aP.5
- Sukul N, Karaboyas A, Csomor PA, et al. Self-reported pruritus and clinical, dialysis-related, and patient-reported outcomes in hemodialysis patients. Kidney Med. 2020;3(1):42–53. doi:10.1016/j.xkme.2020.08.011
- Rayner HC, Larkina M, Wang M, et al. International comparisons of prevalence, awareness, and treatment of pruritus in people on hemodialysis. Clin J Am Soc Nephrol. 2017;12(12):2000–2007. doi:10.2215/CJN.03280317
- Verduzco HA, Shirazian S. CKD-associated pruritus: new insights into diagnosis, pathogenesis, and management. Kidney Int Rep. 2020;5(9):1387–1402. doi:10.1016/j.ekir.2020.04.027
- Combs SA, Teixeira JP, Germain MJ. Pruritus in kidney disease. Semin Nephrol. 2015;35(4):383–391. doi:10.1016/j.semnephrol.2015.06.009
- Ramakrishnan K, Bond CT, Claxton A, et al. Clinical characteristics and outcomes of end-stage renal disease patients with self-reported pruritus symptoms. Int J Nephrol Renovasc Dis. 2014;7:1–12. doi:10.2147/IJNRD.S52985