Pruritus and clinical outcomes in CKD patients not on dialysis
Why is this important?
Itching is a frequent symptom experienced by people with chronic kidney disease (CKD). In a recent study by Scherer, 2023 the associations of CKD-associated pruritus (CKD-aP) with clinical outcomes were investigated.
What did the study show?
4,410 patients from Brazil, France, and the United States, with a median age of 69 years and an average eGFR 29 (21-38) mL/min/1.73 m2, were studied. The authors found that 51% of the patients were bothered by pruritus (itching).
The proportion of patients not at all, somewhat, moderately, very much, and extremely bothered by itching was 49%, 27%, 13%, 7%, and 3%, respectively. Patients with more advanced stages of CKD, older age, and greater comorbidities were more likely to be bothered by itchy skin.
Amongst patients at least moderately bothered, 23% were prescribed at least 1 medication (35% in the United States, 19% in France, 4% in Brazil), including antihistamine (10%), gabapentin (6%), topical corticosteroids (4%), pregabalin (3%), or sedating antihistamine (3%).
Compared to those not at all bothered by pruritus, those who were extremely bothered had a higher risk of all-cause mortality, hospitalisation, and cardiovascular events. Severity of CKD-aP was not associated with CKD progression or initiation of dialysis.
How does this affect you?
These results demonstrate a strong association between severe itching and clinical outcomes, providing your kidney doctors with new insights into the possible adverse consequences of CKD-aP in people not on dialysis. This warrants further exploration by your doctors. Interestingly, there were significant differences between the likelihood of having treatment in the three countries studied.
Other resource
CKDEx has a related article CKD and itching.
Last Reviewed on 26 June 2024
