ASSOCIATED FACTORS WITH UREMIC PRURITUS IN PATIENTS WITH END-STAGE RENAL DISEASE UNDERGOING THRICE- WEEKLY OPD HEMODIALYSIS AND HEMODIAFILTRATION IN NATIONAL KIDNEY AND TRANSPLANT INSTITUTE

 

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https://storage.unitedwebnetwork.com/files/1099/e44b43d5cf10103cfc1ffb396a5ac08c.pdf
ASSOCIATED FACTORS WITH UREMIC PRURITUS IN PATIENTS WITH END-STAGE RENAL DISEASE UNDERGOING THRICE- WEEKLY OPD HEMODIALYSIS AND HEMODIAFILTRATION IN NATIONAL KIDNEY AND TRANSPLANT INSTITUTE

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Germie Anne
Navalta
Germie Anne Navalta ganmd14@gmail.com NKTI Adult Nephrology Quezon City Philippines *
Anthony Russell Villanueva villanueva.russ@gmail.com NKTI Adult Nephrology Quezon City Philippines -
 
 
 
 
 
 
 
 
 
 
 
 
 
Uremic pruritus (UP) is one of the most frequent symptom that gets unnoticed but is the most bothersome in hemodialysis patients. Recognizing the patients with pruritus can bring awareness in addressing this symptom; moreover, to identify the associated factors with uremic pruritus including the demographics, comorbidities, metabolic profile and efficacy of thrice- weekly hemodialysis. The study aimed to use a validated tool in filipino to identify the patients with uremic pruritus and the associated factors contributing to it.
The 5d Itch Scale was granted permission to be used in this study which was forward and back translated. The Filipino version has been validated and was answered by patients with UP. The renal diagnosis, co- morbidities, available laboratories and Kt/V (adequacy of dialysis) at the time pruritus was noted were collected.
A total of 143 patients with end-stage renal disease (ESRD) undergoing thrice-weekly outpatient hemodialysis or hemodiafiltration were included, of whom 54 (38%) experienced uremic pruritus. The degree of itchiness out of the 54: 41% mild to moderate itchiness, 9% severe, 7% unbearable itchiness and 2% for no itchiness in over 2 weeks. Biochemical parameters, including dialysis adequacy (Kt/V), hemoglobin, hematocrit, platelet count, white blood cell count, electrolytes, pre-HD blood urea nitrogen, creatinine, and estimated GFR, were not significantly different between groups. Logistic regression analysis identified two significant diagnostic predictors. Patients with CGN were less likely to develop uremic pruritus (OR = 0.45, 95% CI: 0.21–0.95, p = 0.035). Conversely, those with DKD VS HTNNS were at substantially increased risk (OR = 4.08, 95% CI: 1.67–10.02, p = 0.002). These findings suggest that the underlying etiology of renal disease plays a crucial role in the susceptibility to pruritus.
Demographic, Kt/V, laboratory variables showed no significant association with pruritus. Uremic Pruritus may be influenced more by underlying renal pathology than by dialysis treatment adequacy or biochemical derangements. Importantly, the etiology of ESRD secondary to DKD and HTNNS markedly increased the risk. The absence of other co-morbidities was also associated with a higher prevalence of pruritus.
Kewords