Epidemiology and determinants of pruritus in pre-dialysis chronic kidney disease patients

Solak, Berna; Açıkgöz, Seyyid Bilal; Sipahi, Savaş; Erdem, Teoman

doi:10.1007/s11255-015-1208-5

Cited by 37 publications

(42 citation statements)

References 24 publications

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“…This is similar to findings reported by Solak et al and Berger et al (19,20). This implies that pruritus should be assessed and managed in all CKD patients irrespective of age, gender, stage or etiology.…”

Section: Discussionsupporting

confidence: 93%

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Prevalence, Pattern and Association of Pruritus with Quality of Life in Chronic Kidney Disease Patients Attending Kidney Care Centre, Ondo City, Southwest Nigeria

Adejumo¹,

Akinbodewa²,

Alli³

et al. 2016

Ethiop J Health Sci

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BACKGROUND: Pruritus is a common cutaneous manifestation of chronic kidney disease (CKD). It is associated with poor sleep quality, anxiety and depression which may contribute to reduction in quality of life (QoL). Paying more attention to pruritus in CKD patients may improve their QoL, reduce kidney disease burden and mortality. This study determined the prevalence, pattern and association of pruritus with QoL in CKD patients. MATERIALS AND METHODS: This was a cross-sectional descriptive study carried out in a KidneyCare Centre, Ondo City, Southwest Nigeria. The severity and intensity of pruritus and health-related QoL were assessed using validated instruments. P-value of < 0.05 was taken as significant. RESULTS: There were 91 CKD subjects with a male:female ratio of 2.1:1. Sixty-nine (75.8%) of the CKD patients were not on dialysis while the remaining twenty-two (24.2%) were on maintenance hemodialysis (MHD). Thirty-nine (42.9%) of the CKD subjects had pruritus which was mild in 25(64.1%), moderate in 8(20.5%) and severe in 6(15.4%). Pruritus was more common in MHD patients compared to predialysis CKD patients(50%vs40.6%) p = 0.47. The median pruritus intensity score was also higher in MHD patients compared to predialysis CKD patients (40vs30) p = 0.51. There was no significant association between gender, age, aetiology of CKD, stage of CKD and pruritus. There was a significant correlation between QoL score and pruritus intensity. (p = < 0.001, r = 0.56). CONCLUSION: Pruritus was common among our CKD subjects and it was not significantly associated with age, gender, stage or etiology of CKD. There was a significant association between impaired QoL and pruritus intensity.

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Section: Discussionsupporting

confidence: 93%

“…The prevalence of pruritus in this study is 42.9% which is higher than 18.9% reported by Solak et al (19). The higher prevalence in our study may be due to the fact that the study subjects consisted of both predialysis CKD and MHD patients unlike those in the study by Solak et al who were only predialysis patients.…”

Section: Discussioncontrasting

confidence: 75%

Prevalence, Pattern and Association of Pruritus with Quality of Life in Chronic Kidney Disease Patients Attending Kidney Care Centre, Ondo City, Southwest Nigeria

Adejumo¹,

Akinbodewa²,

Alli³

et al. 2016

Ethiop J Health Sci

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“…In a cross-sectional study of 402 patients with stage 2-5 CKD, the prevalence of CKDaP was 18.9%. 26 In this study, pruritus was not affected by the stage of CKD. In a cross-sectional study of skin manifestations in 200 Indian CKD and ESRD patients (50 each in stages 3, 4, and 5 CKD and 50 patients with ESRD on dialysis), the prevalence of pruritus was 36%.…”

Section: Ckdmentioning

confidence: 47%

Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges

Shirazian¹,

Aina²,

Park³

et al. 2017

IJNRD

103

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Chronic kidney disease-associated pruritus (CKD-aP) is a distressing, often overlooked condition in patients with CKD and end-stage renal disease. It affects ~40% of patients with end-stage renal disease and has been associated with poor quality of life, poor sleep, depression, and mortality. Prevalence estimates vary based on the instruments used to diagnose CKD-aP, and standardized diagnostic instruments are sorely needed. Treatment studies have often yielded conflicting results. This is likely related to studies that are limited by small sample size, flawed designs, and nonstandardized diagnostic instruments. Several large well-designed treatment trials have recently been completed and may soon influence CKD-aP management.

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“…Pruritus is one of the most distressing symptoms in chronic kidney disease (CKD) [2] also termed, "CKD associated pruritus" (CKD-P) [3]. Uremic pruritus is extremely common in patients undergoing hemodialysis [4,5]. For example, a recent study of 18,801 hemodialysis patients demonstrated that pruritus affected approximately 42% of all patients, and 15-49% of patients with chronic renal failure.…”

Section: Introductionmentioning

confidence: 99%

Skin Cutibacterium acnes Mediates Fermentation to Suppress the Calcium Phosphate-Induced Itching: A Butyric Acid Derivative with Potential for Uremic Pruritus

Keshari

Wang

Herr

et al. 2020

JCM

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Pruritus and inflammation associated with accumulation of calcium phosphate (CaP) under the skin are common problems among dialysis patients with chronic kidney disease (CKD). The role of skin commensal microbiota in the CaP-induced uremic pruritus remains uncharacterized. Skin Cutibacterium acnes (C. acnes) can solubilize CaP by the production of short-chain fatty acids (SCFAs), such as butyric acid, through glucose fermentation. Like butyric acid, the N-[2-(2-Butyrylamino-ethoxy)-ethyl]-butyramide (BA-NH-NH-BA), a butyric acid derivative, remarkably induced acetylation of histone H3 lysine 9 (AcH3K9) in keratinocytes. Topical application of fermenting C. acnes, butyric acid or BA-NH-NH-BA onto mouse skin effectively ameliorated CaP-induced skin itching, interleukin (IL)-6 up-regulation in keratinocytes, and extracellular signal-regulated kinase (ERK) 1/2 activation in dorsal root ganglia (DRG). Activation of ERK 1/2 by CaP was markedly reduced in IL-6 knockout mice. Genus Cutibacterium was detected in relatively low abundance in itchy skin of patients with CKD. Our results identify a role for the skin fermenting C. acnes in ameliorating CaP-induced activation of IL-6/p-ERK signaling and resulting skin inflammation. Furthermore, we provide evidence for the potential therapeutic efficacy of BA-NH-NH-BA as a postbiotic for the treatment of uremic pruritus.

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Epidemiology and determinants of pruritus in pre-dialysis chronic kidney disease patients

Cited by 37 publications

References 24 publications

Prevalence, Pattern and Association of Pruritus with Quality of Life in Chronic Kidney Disease Patients Attending Kidney Care Centre, Ondo City, Southwest Nigeria

Prevalence, Pattern and Association of Pruritus with Quality of Life in Chronic Kidney Disease Patients Attending Kidney Care Centre, Ondo City, Southwest Nigeria

Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges

Skin Cutibacterium acnes Mediates Fermentation to Suppress the Calcium Phosphate-Induced Itching: A Butyric Acid Derivative with Potential for Uremic Pruritus

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