Prevalence and characterization of uremic pruritus in patients undergoing hemodialysis: uremic pruritus is still a major problem for patients with end-stage renal disease

Zucker, Inbar; Yosipovitch, Gil; David, Michael; Gafter, Uzi; Boner, G

doi:10.1016/s0190-9622(03)02478-2

Cited by 232 publications

(226 citation statements)

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“…However, majority of the patients with pruritus 18 (90%) reported no change during rest at daytime and only 1 (5%) reported its exacerbation during rest (Table 5). Our findings was in agreement with Zucker et al 9 study, who reported pruritus was not evenly distributed over the day, rather it occurred more often and with greater intensity at night. The probable cause of worsening of pruritus at night is at least in part by physiologic changes with diurnal rhythm, which could be related to expression of circardian rhythms of peptides and their receptors in neurons.…”

Section: Discussionsupporting

confidence: 94%

Dermatologic Manifestations In Chronic Kidney Disease Patients On Hemodialysis

Shrestha

Mathur

2016

Nepal J Dermatol Venereol & Leprol

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Introduction: Dermatologic changes are frequently seen in chronic kidney disease (CKD) patients. Early identification of these manifestations helps timely institution of treatment and prevention of progression of CKD.Objectives: The aim of this study was to evaluate the frequency and pattern of dermatologic problems among CKD patients who are on maintenance hemodialysis in our population. Material and Methods:A hospital based cross sectional comparative study was conducted. Fifty patients with CKD on hemodialysis were compared with the same number of non CKD patients. All the patients were clinically examined. Complementary diagnostic measures such as skin biopsy, gram stain, potassium hydroxide mounting and culture sensitivity of the lesions were carried out when necessary.Results: At least one dermatologic manifestation was present in 86% of the patients and changes were seen commonly in CKD patients who had GFR <15ml/min (83.8%). Cutaneous manifestations were significantly associated with CKD patients than control (p<0.001) but not with the duration of CKD and duration of hemodialysis. Thirty seven patients (74%) were having cutaneous lesions, commonest being xerosis (52%) followed by pruritus (40%) and hyperpigmentation (32%). Nail, mucous membrane and hair changes were present in 56%, 22% and 12% respectively, commonest being white nail (30%), furred tongue (18%), telogen effluvium (10%) respectively. Conclusion:In our study, dermatologic manifestations were common in CKD patients with GFR <15ml/min. Cutaneous and nail changes were seen in 74% and 56% of the CKD patients undergoing hemodialysis, commonest changes being xerosis and white nail respectively.

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Section: Discussionsupporting

confidence: 94%

Dermatologic Manifestations In Chronic Kidney Disease Patients On Hemodialysis

Shrestha

Mathur

2016

Nepal J Dermatol Venereol & Leprol

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“…We found that a third of the patients (75.5%) that received hemodialysis treatment suffered from pruritus afterwards in various degrees and more than half had pruritus at the time of the study period. Zucker et al reported that 66.0% of patients undergoing dialysis suffered from pruritus afterwards and 48.0% had pruritus at the time of the study period (9). years.…”

Section: Discussionmentioning

confidence: 99%

An Important Problem Among Hemodialysis Patients: Uremic Pruritus

Akça¹,

Taşçı²

2014

Turk Neph Dial Transpl

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ObJECTIVE: This study was conducted in order to determine the incidence of uremic pruritus in hemodialysis patients and to explore the associated factors. MATErIAL and METHODS:This descriptive study included 204 patients. Official permissions from the institutions and informed consents of the patients were obtained. The data were gathered using a questionnaire form designed by the investigators and the Visual Analogue Scale (VAS). The t test, one-way ANOVA and logistic regression analysis were used for the statistical analyses of the data. rESULTS:We found that 75.5% of the patients suffered from pruritus after hemodialysis treatment was initiated and 64.2% of them had an average level of pruritus (6.0±2.0) at the time of the study. It was noted that 37.4% had wounds caused by pruritus and 61.1% woke up from their sleep due to pruritus. Patients who were aged ≥ 65 were 3.91 times more likely to suffer from very severe pruritus compared to other age groups and patients with dry skin were 9.90 times more likely to suffer from very severe pruritus as compared to those with normal skin (p<0.05) CONCLUSION:In light of these results, it may be recommended that patients who suffer from uremic pruritus should be provided with the necessary care and training programs, taking into account their individual and disease-related characteristics. KEy wOrDS: Uremic pruritus, Hemodialysis, Affecting factorsÖz AMAÇ: Bu çalışma, hemodiyaliz tedavisi alan bireylerin yaşadığı üremik kaşıntı ve kaşıntıyla ilişkili faktörleri belirlemek amacıyla yapılmıştır. GErEÇ ve yÖNTEMLEr:Tanımlayıcı nitelikte yapılan bu çalışma, araştırmaya katılmayı kabul eden 204 kişi üzerinde yapılmıştır. Çalışmada, kurum izni ve bireylerden yazılı onam alınmıştır. Veriler araştırmacılar tarafından oluşturulan anket formu ve Visual Analog Skala (VAS) aracılığı ile toplanmıştır. Verilerin istatistiki değerlendirilmesinde, Student t, ANOVA testi ve lojistik regresyon analizi kullanılmış ve p<0.05 anlamlı olarak kabul edilmiştir.bULGULAr: Bireylerin %75,5'inin hemodiyaliz tedavisine başladıktan sonra kaşıntısının olduğu, %64,2'sinin ise çalışmanın yapıldığı anda ortalama 6,0±2,0 (2-10) düzeyde (şiddetli) kaşıntı yaşadıkları saptanmıştır. Bireylerin %37,4'inin kaşıntı sonucu vücudunda yaralar olduğu ve %61,1'inin kaşıntı nedeniyle uykusundan uyandığı belirlenmiştir. Diğer yaş gruplarıyla karşılaştırıldığında 65 yaş üstü hastaların 3,91 kat ve derisi kuru olan hastaların ise derisi normal olanlara göre 9,90 kat daha şiddetli kaşıntı yaşadığı tespit edilmiştir (p<0,05). SONUÇ:Bu sonuçlar doğrultusunda, üremik kaşıntı yaşayan bireylerin bireysel ve hastalık özellikleri dikkate alınarak eğitim ve bakım yapılması önerilebilir.

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“…Not only sleep disorders and depressive symptoms, but also various other symptoms, such as indefinite complaints associated with HD therapy, can occur. The most frequently reported complaints caused by sleep disorders are restless legs syndrome and uremic pruritus [24,25]. In addition, muscle cramps due to body fluid imbalances and IDH can also cause sleep problems [26].…”

Section: Discussionmentioning

confidence: 99%

Relationship between Dream Anxiety in Recurrent Nightmare and Indefinite Complaints in Patients Undergoing Maintenance Hemodialysis: A Cross-sectional Study

Tsuji

Suzuki²,

Hitomi³

et al. 2018

IJAE

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Abstract:The objective of this study was to investigate the relationship between recurrent nightmare and indefinite complaints and to determine the explanatory variables of indefinite complaints related to nightmares in hemodialysis (HD) patients. Sleep quality and dream anxiety in nightmare were assessed with the Athens Insomnia Scale and Van Dream Anxiety Scale. Using a visual analog scale and the Beck Depression Inventory, we assessed the presence of indefinite complaints and levels of depressive symptoms, respectively. Moreover, logistic regression analysis was performed to determine the risk factors of dream anxiety in recurrent nightmare. The presence of feelings of malaise was an independent risk factor of recurrent nightmare (OR, 1.360; p = 0.0083). Adjustment for the presence of feelings of malaise could help to reduce the frequency of nightmares or sleep disorders in patients undergoing HD treatment. Our findings will be useful when considering adjustment of the HD dose.

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Prevalence and characterization of uremic pruritus in patients undergoing hemodialysis: uremic pruritus is still a major problem for patients with end-stage renal disease

Cited by 232 publications

References 18 publications

Dermatologic Manifestations In Chronic Kidney Disease Patients On Hemodialysis

Dermatologic Manifestations In Chronic Kidney Disease Patients On Hemodialysis

An Important Problem Among Hemodialysis Patients: Uremic Pruritus

Relationship between Dream Anxiety in Recurrent Nightmare and Indefinite Complaints in Patients Undergoing Maintenance Hemodialysis: A Cross-sectional Study

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