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Xie Q, Hu N, Chen Y. Chronic kidney disease-associated pruritus significantly impacts on quality of life of patients on haemodialysis and associates with increased levels of serum calcium and phosphorus. Postgrad Med J 2021; 98:e16. [PMID: 37066508 DOI: 10.1136/postgradmedj-2020-139688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/09/2021] [Accepted: 03/24/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE OF THE STUDY Chronic kidney disease-associated pruritus (CKD-aP) is common among patients on maintenance haemodialysis (HD). We performed a study to explore the clinical features of patients with CKD-aP and evaluate the impact of CKD-aP on the quality of life of HD patients. STUDY DESIGN Patients who were receiving regular HD over 3 months were recruited. Quality of life was quantified by the Short Form-12 (SF-12) questionnaire. Pruritus was evaluated by the 5D-Itch Scale. Demographic characteristics and biochemical indicators were obtained from the medical record system. Multiple linear regression was used to assess the association between pruritus and targeting factors. The relationship between the scores on the 5D-Itch Scale and SF-12 was analysed using multiple linear regression, adjusted for other factors, to demonstrate the impact of CKD-aP on the quality of life of HD patients. RESULTS In total, 269 out of 301 (89.4%) patients accomplished all investigations. The prevalence of CKD-aP in our cohort was 40.9%. Age (B=0.339, p=0.042), treatment with haemoperfusion (B=1.853, p=0.018), and serum level of calcium (B=3.566, p=0.008) and phosphorus (B=1.543, p=0.002) were independently associated with pruritus. Score on the 5D-Itch Scale negatively impacted on physical component summary (B=-0.778, p<0.001) and mental component summary (B=-0.675, p<0.001). CONCLUSIONS Pruritus significantly aggravates the quality of life of HD patients. Irregularity in the metabolism of calcium and phosphorus may partially explain the mechanism of CKD-aP. More effective treatment of CKD-MBD may help to prevent pruritus and improve patients' mental and physical health conditions.
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Affiliation(s)
- Qiuyu Xie
- Renal Division,Department of internal medicine, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China
| | - Nan Hu
- Renal Division,Department of internal medicine, Peking University First Hospital, Beijing, China .,Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China
| | - Yuqing Chen
- Renal Division,Department of internal medicine, Peking University First Hospital, Beijing, China.,Institute of Nephrology, Peking University, Beijing, China.,Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Beijing, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China
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Yoosefinejad AK, Karjalian F, Momennasab M, Jahromi SE. Reliability and validity of the Persian version of 5-D itching scale among patients with chronic kidney disease. BMC Nephrol 2021; 22:16. [PMID: 33413176 PMCID: PMC7791997 DOI: 10.1186/s12882-020-02220-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 12/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hemodialysis is considered a major therapeutic method for patients with chronic kidney disease. Pruritus is a common complaint of hemodialysis patients. The 5-D pruritus scale is amongst the most common tools to evaluate several dimensions of itch. Psychometric properties of the 5-D scale have not been evaluated in Persian speaking population with hemodialysis; hence, the objective of this study was to assess reliability and validity of the Persian version of the scale. METHODS Ninety hemodialysis patients (men: 50, women: 40, mean age: 54.4 years) participated in this cross-sectional study. The final Persian version of 5-D scale was given to the participants. Tests Compared: One-third of the participants completed the scale twice within 3-7 days apart to evaluate test- retest reliability. Other psychometric properties including internal consistency, absolute reliability, convergent, discriminative and construct validity, floor/ceiling effects were also evaluated. RESULTS The Persian 5-D scale has strong test-retest reliability (ICC= 0.98) and internal consistency (Cronbach's alpha= 0.99). Standard error of measurement and minimal detectable change were 0.33 and 0.91, respectively. Regarding convergent validity, the scale had moderate correlation with numeric rating scale (r =0.67) and quality of life questionnaire related to itch (r = 0.59). Exploratory factor analysis revealed two factors within the scale. No floor or ceiling effect was found for the scale. CONCLUSION The Persian version of 5-D the itching scale is a brief instrument with acceptable reliability and validity. Therefore, the scale could be used by experts, nurses, and other health service providers to evaluate pruritus among Persian speaking hemodialysis patients.
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Affiliation(s)
- Amin Kordi Yoosefinejad
- Physical therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Karjalian
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Momennasab
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Zand St., Namazee Sq, Shiraz, 7193613119, Iran.
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Ur Rehman I, Han LL, Khan TM, Alworafi Y, Suleiman A. Comparative Analysis of Chronic Kidney Disease-Associated Pruritus: A Multi-Ethnic Study among Patients on Hemodialysis. Arch Pharm Pract 2021. [DOI: 10.51847/asmu6akyoy] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Rehman IU, Lai PS, Kun LS, Lee LH, Chan KG, Khan TM. Chronic Kidney Disease-Associated Pruritus and Quality of Life in Malaysian Patients Undergoing Hemodialysis. Ther Apher Dial 2019; 24:17-25. [PMID: 31152625 DOI: 10.1111/1744-9987.12862] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/01/2019] [Accepted: 05/30/2019] [Indexed: 11/30/2022]
Abstract
CKD-associated pruritus is one of the common symptoms in patients undergoing dialysis, thus contributing to the diminished and compromised quality of life. This study aimed to explore the association between the CKD-associated pruritus on quality of life of patients undergoing hemodialysis in Malaysia. A cross-sectional multicenter study, carried out from February to September 2017 at tertiary care settings in Kuala Lumpur, Malaysia. Patients aged 18 years and above, undergoing hemodialysis, understanding Malay language and willing to participate were included. The CKD-associated pruritus was assessed by using Malay 5D-itch scale and Malay FANLTC questionaiare. To determine the factors associated with pruritus and quality of life, multivariate logistic regression analysis was used having P value < 0.05 as statistically significant. Among n = 334 recruited patients with a response rate of 100%, 59.6% were males and total of 61.3% were having CKD-associated pruritus. The results showed a statistically significant weak negative correlation between CKD-associated pruritus and quality of life. Multivariate linear regression revealed none of these factors were found to be associated with pruritus; however, CKD-associated prurtius was found to be associated with quality of life score. CKD-associated pruritus is have a negative impact on the patient's quality of life including physical, social, mental/emotional, and functional well-being. Despite the high prevalence and negative impact of CKD-associated pruritus on quality of life, it is disregarded by most health care professionals. It is thus pertinent to monitor the potential risk factors and consider providing timely treatment implications for CKD-associated pruritus in hemodialysis patients, in order to improve their quality of life.
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Affiliation(s)
- Inayat U Rehman
- School of Pharmacy, Monash University, Bandar Sunway, Malaysia.,Department of Pharmacy, Abdul Wali Khan University Mardan, Mardan, Pakistan
| | - Pauline Sm Lai
- Department of Primary Care Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Lim S Kun
- Department of Nephrology, University of Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Learn H Lee
- School of Pharmacy, Monash University, Bandar Sunway, Malaysia.,Biomedical Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia.,Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand
| | - Kok G Chan
- International Genome Centre, Jiangsu University, Zhenjiang, China.,ISB (Genetics), Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Tahir M Khan
- School of Pharmacy, Monash University, Bandar Sunway, Malaysia.,Institute of Pharmaceutical Sciences, University of Veterinary and Animal Science, Lahore, Pakistan
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Rehman IU, Lai PSM, Lim SK, Lee LH, Khan TM. Sleep disturbance among Malaysian patients with end-stage renal disease with pruritus. BMC Nephrol 2019; 20:102. [PMID: 30909887 PMCID: PMC6434782 DOI: 10.1186/s12882-019-1294-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 03/13/2019] [Indexed: 11/24/2022] Open
Abstract
Background Chronic kidney disease-associated pruritus (CKD-aP) is a well-recognized, frequent and compromising complication among patients on hemodialysis. Despite advancement in basic medical sciences, CKD-aP is still a major complication and a challenge for both physicians and patients to manage. The aim of this study was to estimate the prevalence of CKD-aP among hemodialysis patients in Malaysia, to determine the impact of CKD-aP on sleep quality and any factors associated with CKD-aP. Method A multi-centered, cross-sectional study design was conducted from February 2017 to September 2017 at a tertiary hospital and its affiliated dialysis centers, in Kuala Lumpur, Malaysia. Included were patients > 18 years of age who were undergoing hemodialysis and could understand Malay. Participants were asked to fill the Malay 5D-itch scale and the Malay Pittsburgh sleep quality index (PSQI) upon recruitment. Results A total of 334/334 patients were recruited (response rate = 100%). The majority were male (59.6%) and Chinese (61.7%). A total of 61.3% had pruritus, of which most patients (63.4%) reported that their pruritus was mild. More than half (54.1%) reported that they slept > 6 h, and 93.2% experienced no sleep disturbances during the night. However; the overall PSQI median score [IQR] was 6.0 [5.0–9.0]. No significant association was found between demographic and clinical characteristics of patients with the severity of pruritus. Patients with moderate to severe pruritus were found to be 5.47 times more likely to experience poor sleep quality as compared to patients with mild or no pruritus. Conclusion In Malaysia, the prevalence of CKD-aP was 61.3%, of which the majority reported that their pruritus was mild. Patients with moderate to severe pruritus were found to be 5.47 times more likely to experience poor sleep quality as compared to patients with mild or no pruritus.
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Affiliation(s)
- Inayat Ur Rehman
- School of Pharmacy, Monash University, Jalan Lagoon Selatan, Bandar Sunway, 47500, Selangor Darul Ehsan, Malaysia. .,Department of Pharmacy, Abdul Wali Khan University Mardan, Mardan, Pakistan.
| | - Pauline Siew Mei Lai
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Soo Kun Lim
- Department of Medicine (Division of Nephrology), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Learn Han Lee
- School of Pharmacy, Monash University, Jalan Lagoon Selatan, Bandar Sunway, 47500, Selangor Darul Ehsan, Malaysia.,Novel Bacteria and Drug Discovery Research Group, Microbiome and Bioresource Research Strength, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500, Bandar Sunway, Selangor Darul Ehsan, Malaysia.,Institute of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, 510006, Guangzhou, People's Republic of China.,Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand
| | - Tahir Mehmood Khan
- School of Pharmacy, Monash University, Jalan Lagoon Selatan, Bandar Sunway, 47500, Selangor Darul Ehsan, Malaysia. .,Institute of Pharmaceutical Sciences, University of Veterinary and Animal Science, Outfall Campus, Civil Lines, Lahore, Pakistan.
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