Chinese Journal of Blood Purification

Chinese Journal of Blood Purification ›› 2022, Vol. 21 ›› Issue (11): 813-817,839.doi: 10.3969/j.issn.1671-4091.2022.11.006

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A multi-center clinical research on the occurrence and influencing factors of pruritus in maintenance hemodialysis patients

BAO Hong-da, WANG Xiao-xia, ZHANG Li-ming, WANG Ying-deng, ZOU Jian-zhou, FU Peng, MA Jun, LI Jiang-tao, WANG Feng, ZHANG Ran, WANG Nian-song, JIANG Geng-ru   

  1. Department of Nephrology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai 201306, China; 2Department of Nephrology, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China; 3Department of Nephrology, Zhabei Central Hospital, Jing'an District, Shanghai 200070, China; 4Department of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China; 5Department of Nephrology, Wusong Hospital, Zhongshan Hospital, Fudan University, Shanghai 200940, China; 6Department of Nephrology, Shanghai East Hospital, Shanghai 200433, China; 7Department of Nephrology, Shanghai Jing'an District Central Hospital, Shanghai 200040, China; 8Department of Nephrology, Shanghai Tongji Hospital, Shanghai 200092, China; 9Department of Nephrology, Shanghai Eighth People's Hospital, Shanghai 200235, China; 10Department of Nephrology, Shanghai Tianyou Hospital, Shanghai 200331, China; 11Department of Nephrology, Xinhua Hospital，Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
  • Received:2022-07-21 Revised:2022-08-30 Online:2022-11-11 Published:2022-11-12
  • Contact: 年松 201306 上海，1上海交通大学附属第六人民医院肾内科； 蒋更如 200092 上海，11上海交通大学附属新华医院肾内科 E-mail:Email:wangniansong2012@163.com；jianggeng-ru@hotmail.com

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Abstract: Objective To investigate the incidence, severity and risk factors of pruritus in maintenance hemodialysis (MHD) patients.  Methods  The MHD patients in the nephrology departments of eleven hospitals were enrolled in this study. Patient self-reported pruritus was assessed by the Visual Analog Scale (VAS). The observed indicators included current dialysis scheme, dialysis age, complications, medications, and laboratory tests relating to calcium and phosphorus metabolism.  Results  A total of 1,540 patients were investigated, with 78.7% reporting pruritus, of which 34.2% had moderate to severe pruritus; the overall mean pruritus VAS score was 2.85±2.52. Lower Kt/V (β=-0.562, 95% CI:-0.916～-0.207, P=0.002), use of calcimimetics (β=-1.094, 95% CI: -1.462～-0.725, P＜0.001), HD+HDF protocol (β=0.604, 95% CI:0.119～1.089, P=0.015), HD+HDF+HP protocol (β=0.967, 95% CI:0.453～1.481, P＜0.001), hemodialysis combined with peritoneal dialysis (β=0.989, 95% CI:0.078～1.900, P=0.033), use of calcitriol (β=0.564, 95% CI:0.250～0.877, P＜0.001), use of topical antipruritics (β=2.740, 95% CI:2.052～3.428, P＜0.001), anemia (β=0.575, 95% CI:0.245～0.905, P＜0.001), chronic kidney disease-mineral and bone disease (β=0.841, 95% CI:0.527～1.155, P＜0.001), and higher calcium-phosphorus product (β=1.898, 95% CI:0.645～3.152, P=0.003) were associated with higher risk of pruritus.  Conclusion The higher prevalence of pruritus in MHD patients is mainly associated with the abnormalities of calcium and phosphorus metabolism.

Key words: Hemodialysis, Pruritus, Calcium and phosphorus metabolism

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