Prevalence of pruritus in spanish patients with chronic kidney disease and affectation of quality of life

Abstract BACKGROUND AND AIMS The prevalence of chronic kidney disease–associated pruritus (CKD-aP) found in different studies ranges from 40% to 90% in patients undergoing haemodialysis, and from 19% to 29% in non-dialysed patients. However, despite pruritus negatively affect the quality of life (QoL) and clinical outcomes as well as increase the risk of mortality, clinicians still tend to underestimate the number of patients with CKD-aP. This study was conducted to estimate the prevalence of pruritus and its impact in different dimensions of QoL in the Spanish population with CKD. METHOD A short survey was designed using seven questions included in several validated tools for pruritus assessment. The questionnaire was distributed by the Spanish Society of Nephrology to all their members in the framework of the Pruritus Week. Nephrologists visiting advanced CKD patients asked them to answer the questionnaires voluntarily. RESULTS A total of 1605 patients (haemodialysis 92%, peritoneal dialysis 5% and non-dialysis 3%) answered the questionnaire. A prevalence of CKD-aP of 50.5% was reported, 26.7% being moderate-to-severe. As shown in figure 1, the prevalence was higher in non-dialysis advanced CDK patients suggesting a benefit of dialysis in reducing itch. CKD-aP patients reported itching throughout their body and at any part of the day, but more at night. The percentage of patients with mood changes increased as the severity of itch increased, being anguish and lack of rest the parameters that were more highly affected. An increase in depression was also observed. Sexual function and desire impairment increased as severity of CKD-aP increased. Finally, CKD-aP patients reported higher sleeping disturbances than patients with no pruritus (difficulty to sleep, restless sleep and intake of sleep medication), which enhanced with the increase of pruritus severity. CONCLUSION CKD-aP is highly prevalent in patients with advanced CKD (non-dialysis and dialysis), which affects patients’ quality of life by inducing mood changes, including depression, impairing sexuality and affecting sleep.