Patients with chronic kidney disease-associated pruritus (CKD-aP) experience numerous adverse effects, including adverse clinical events as well as adverse patient-reported outcomes. However, according to Angelo Karaboyas, PhD, and colleagues, previous studies of CKD-aP have concentrated on a single baseline assessment, resulting in few available data on the course of severity of CKD-aP over time.
The researchers analyzed data from DOPPS (Dialysis Outcomes and Practice Patterns Study) on 8178 hemodialysis patients in 21 countries who had two assessments of CKD-ap 12 months apart.
A question on the Kidney Disease Quality of Life 36 item short form survey (KDQOL-36™) was used to assess CKD-aP intensity. The question asked about the extent patients were bothered by pruritus over the previous 4 weeks: not at all, somewhat, moderately, very much, extremely. Responses at month 12 were stratified by baseline responses.
The proportion of patients reporting being at least moderately bothered by pruritus was 37% at baseline, 37% 12 months later, and 51% at either assessment (including 28% at least very much bothered). Of the patients responding being bothered by pruritus “not at all” or “somewhat” at baseline, 22% became at least moderately bothered 1 year later.
Of the patients reported being at least moderately bothered by pruritus at baseline, 60% remained at least moderately bothered at the 12-month assessment. Overall, 43% of patients reported the same response at baseline and at 12 months, compared with 28% whose pruritus improved and 28% whose pruritus worsened
In conclusion, the authors said, “Our findings suggest that at least half of chronic hemodialysis patients were affected by CKD-aP over the course of 1 year. CKD-aP symptoms remained unresolved 12 months later for the majority of hemodialysis patients bothered by itchy skin at baseline, reflecting an unmet medical need. Future research should investigate potential causes of CKD-aP symptoms more systematically as well as treatments used and their effectiveness. This will also highlight how changes in CKD-aP intensity may impact other key patient-reported outcomes.”