Skin Chromaticity Influences the Occurrence but Not the Severity of Uraemic Pruritus in Dialysis Patients: A Single-Center Analysis

 

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https://storage.unitedwebnetwork.com/files/1099/51416922bbd1408fe31de07b57fc5d87.pdf
Skin Chromaticity Influences the Occurrence but Not the Severity of Uraemic Pruritus in Dialysis Patients: A Single-Center Analysis

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Li
Yang
Li Yang 376667286@qq.com Yunyang County People's Hospital Department of Nephrology Chongqing China *
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Uraemic pruritus (UP) is a frequent and distressing complication in dialysis patients, but its mechanisms remain poorly understood. Beyond biochemical and neurological factors, the role of skin chromaticity—reflecting melanin and hemoglobin content—has rarely been examined. This study investigated the association between skin color parameters and both the occurrence and severity of post-dialysis pruritus in chronic kidney disease (CKD) patients.

A total of 256 dialysis patients from a single center were enrolled. Pruritus severity was assessed using the UP-Dial scale and classified as no (n = 90), mild (n = 120), moderate (n = 26), or severe (n = 20). Skin color at healthy sites was measured with a colorimeter to obtain CIE-Lab* values, and the Individual Typology Angle (ITA°) was used for skin type classification. Associations between color parameters and pruritus outcomes were analyzed.

Significant differences were observed in the distribution of pruritus occurrence among skin color groups defined by ITA° (p = 0.0013), with patients in the “Very Light” skin type showing a relatively higher proportion of those without pruritus. Multivariate linear regression further identified skin lightness (L*) and Individual Typology Angle (ITA°) as negative predictors of pruritus occurrence (β = –0.153, p < 0.001; β = –0.052, p < 0.001, respectively), whereas yellowness (b*) was a positive predictor (β = 0.153, p = 0.013). 

In terms of severity, across skin tone categories, lighter skin groups (Very Light, Light) showed a predominance of mild pruritus (>70%), while intermediate tones exhibited a more balanced distribution between mild and moderate-to-severe cases. Darker skin types (Tan, Brown) displayed a slightly higher proportion of severe pruritus. However, no significant differences were found in pruritus severity distribution across ITA° groups (p = 0.248). Likewise, multivariate regression indicated no significant associations between pruritus severity and skin color parameters (L*: p = 0.315; a*: p = 0.152; b*: p = 0.436; ITA°: p = 0.348).

This single-center study suggests that skin chromaticity may influence the likelihood of developing post-dialysis pruritus, though it does not appear to affect its severity. These findings highlight skin color as a potential individual-level factor contributing to susceptibility to uraemic pruritus, warranting validation in larger, multi-center studies.

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