Abstract: Objective  To explore the influencing factors for skin itching in uremic hemodialysis patients and to construct a column chart model for prediction analysis.  Methods  A total of 162 uremic hemodialysis patients admitted to Huai'an Second People's Hospital (Huai'an Hospital affiliated to Xuzhou Medical University) from July 2020 to December 2022 were recruited as the study subjects. They were grouped into a skin itching group (96 cases) and a non-skin itching group (66 cases) based on the symptom of skin itching. Clinical data were collected from the patients. Logistic regression was applied to analyze the risk factors for skin itching in uremic hemodialysis patients. R software was applied to construct a column chart model, and calibration curve was applied to verify the consistency of the mode. The area under the ROC curve was applied to evaluate the predictive value and discrimination ability of the model.  Results  Ninety-six cases (59.26%) of the 162 uremic hemodialysis patients had pruritus. Univariate analysis showed that diabetes history (χ2=5.569, P=0.018), parathyroid hormone (t=13.510, P<0.001), β2 microglobulin (t=11.836, P<0.001), serum phosphorus (t=10.478, P=0.001) and C-reactive protein (t=13.221, P<0.001) were significantly different between skin itching group and non-skin itching group. Multivariate logistic regression showed that β2 microglobulin (OR=1.451, 95% CI: 1.217～1.731, P<0.001), serum phosphorus (OR=7.455, 95% CI: 1.194～46.533, P=0.032), and C-reactive protein (OR=10.929, 95% CI: 4.086～29.234, P<0.001) were the independent risk factors for itching in uremic hemodialysis patients. The nomogram prediction model had better differentiation (area under ROC curve=0.977, 95% CI:0.956～0.998) and consistency (Hosmer-Lemeshow goodness of fit test, χ2=10.065, P=0.261) abilities.  Conclusion   This study constructs a column chart model for predicting the risk of skin itching in uremic hemodialysis patients based on three risk factors: β2 microglobulin, serum phosphorus, and C-reactive protein. This model has better discrimination and consistency abilities, and is expected to become an important tool for predicting the risk of skin itching in uremic hemodialysis patients.

Key words: Hemodialysis, Skin itch, Column chart