One in 4 patients with non-dialysis chronic kidney disease (ND-CKD) experiences moderate to extreme pruritus, a new study finds.

Of 3780 patients with ND-CKD who completed questionnaires in the international CKDopps (CKD Outcomes and Practice Patterns Study), 24% complained of moderate to severe pruritus that was “very” or “extremely” bothersome. These included 24% of patients in Brazil, 29% in the United States, and 23% in France.

Certain individuals appeared more prone to pruritus, Nidhi Sukul, MD, of the University of Michigan in Ann Arbor, and colleagues reported in the Clinical Journal of the American Society of Nephrology. Older patients, females, and those with stage 5 CKD, lung disease, diabetes, or diagnosed depression were more likely to report pruritus.

Men and women with severe pruritus reported poor mental and physical health. They had physical and mental component scores that were 3.5 and 2.3 points lower, respectively, than patients without pruritus. In addition, they were nearly twice as likely to report depressive symptoms and restless sleep on the CES-D.

Less than 10% of patients, including those with moderate to extreme pruritus, received treatment with antihistamines, gabapentin, or pregabalin.

“One of the main goals of managing chronic disease is alleviating symptoms; however, this is only possible when we are aware of the suffering patients endure,” Dr Sukul commented in a news release from the American Society of Nephrology.

“This research gives us a uniquely international look at how important it is to ask our patients with chronic kidney disease if and how they are affected by pruritus. Some drugs have been shown to largely improve pruritus-related symptoms for a substantial percentage of patients, but even if we do not have a universally effective treatment for pruritus, recognizing that pruritus ails our patients and affects their quality of life will make them feel heard and enhance the patient-physician relationship in discussing approaches that may help provide relief from pruritus.”

References

Sukul N, Speyer E, Tu C, Bieber B, et al. Pruritus and patient reported outcomes in non-dialysis CKD. Clin J Am Soc Nephrol. DOI: 10.2215/CJN.09600818

Itchy skin affects the health and quality of life of many patients with kidney disease. American Society of Nephrology; April 5, 2019.