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Assessment of the psychological burden associated with pruritus in hemodialysis patients using the kidney disease quality of life short form

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Abstract

Purpose

To assess whether depression symptoms, poor sleep and dry skin bother explain association between pruritus and the burden of kidney disease in maintenance hemodialysis (MHD) patients.

Methods

Cross-sectional study of 980 patients from a prospective study in dialysis units of Salvador, Brazil (PROHEMO). The Kidney Disease Quality of Life Short Form was used to determine scores of kidney disease burden (KDB) and sleep with higher scores indicating lower perceived burden and better sleep quality, respectively. The Center for Epidemiological Studies Depression Scale was used for depression symptoms.

Results

Prevalence of severe pruritus (very much or extreme) was 19.4%. Significantly (P < 0.001) lower mean KDB score by 11.44 points was observed for patients with severe pruritus (34.18 ± 27.51) than for those with no pruritus (45.62 ± 30.73). Severe pruritus was associated with poorer sleep quality, higher odds of dry skin bother and higher depression symptoms score. Association of pruritus with KDB score was virtually eliminated after adjustment for sleep, dry skin bother and depression symptoms.

Conclusions

This study shows strong associations of severe pruritus with higher depression symptoms, poorer sleep and dry skin bother among MHD patients. The results support special attention to MHD patients with pruritus who often face high psychological burden.

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Abbreviations

BMI:

Body Mass Index

CaAlb :

Albumin-corrected serum calcium

CaxPO4 :

Calcium-phosphate product

CES-D:

Center for Epidemiological Studies Depression Scale

CKD:

Chronic kidney disease

DOPPS:

Dialysis Outcome and Practice Patterns Study

HCV:

Hepatitis C virus

HIV:

Human immunodeficiency virus

HRQOL:

Health-related quality of life

KDB:

Kidney Disease Burden

KDQOL-SF:

Kidney Disease Quality of Life Short Form

Kt/V :

Dialysis dose

MHD:

Maintenance hemodialysis patients

PO4 :

Phosphate

PROHEMO:

Prospective Study of the Prognosis of Chronic Hemodialysis Patients

PTH:

Parathyroid hormone

RLS:

Restless legs syndrome

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Acknowledgments

The PROHEMO has been supported by research grants from “The Brazilian National Council for Scientific and Technological Development (CNPq)”, grants #484743/2006-6 and #308068/2006-8. Preliminary results were present as abstract in the Renal Week 2010 in Denver, CO.

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Authors and Affiliations

  1. Núcleo de Epidemiologia Clínica e Medicina Baseada em Evidências, Hospital Universitário Professor Edgar Santos, Universidade Federal da Bahia, Rua Doutor Augusto Viana s/n, Canela, Salvador, BA, 40110-040, Brazil

    Gildete Barreto Lopes, Fernanda Conceição Pereira Nogueira, Milena Reis de Souza & Antonio Alberto Lopes

  2. Diretoria Médica da Clinica NEPHRON-Itapuã, Salvador, BA, Brazil

    Maria Auxiliadora Penalva

  3. Diretoria Médica da Clinica NEPHRON-Barris, Salvador, BA, Brazil

    Josete Leão de Amorim

  4. Arbor Research Collaborative for Health, Ann Arbor, MI, USA

    Ronald L. Pisoni & Bruce M. Robinson

  5. Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, BA, Brazil

    Antonio Alberto Lopes

Authors
  1. Gildete Barreto Lopes
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  2. Fernanda Conceição Pereira Nogueira
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  3. Milena Reis de Souza
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  5. Josete Leão de Amorim
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  8. Antonio Alberto Lopes
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Correspondence to Antonio Alberto Lopes.

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Lopes, G.B., Nogueira, F.C.P., de Souza, M.R. et al. Assessment of the psychological burden associated with pruritus in hemodialysis patients using the kidney disease quality of life short form. Qual Life Res 21, 603–612 (2012). https://doi.org/10.1007/s11136-011-9964-x

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  • DOI: https://doi.org/10.1007/s11136-011-9964-x

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