SP295PRURITIS IN CHRONIC KIDNEY DISEASE PATIENTS: EARLY RESULTS FROM CKDOPPS

Abstract

Introduction and Aims: Pruritus in hemodialysis (HD) patients ( pts) is associated with a higher prevalence of comorbidities, worse biochemical profiles, poorer mental and physical quality of life, higher probability of depression and poorer sleep quality. The prevalence of pruritus in HD pts is nearly 40%, compared to 8.4% - 16.7% reported in the general population. However, little is known about pruritus in chronic kidney disease (CKD) pts. Here we describe the prevalence of pruritus in CKD pts, stratified by stage, and identify potential predictors of pruritus in this population. Methods: CKDopps and DOPPS (CKD and Dialysis Outcomes and Practice Patterns Study) are international prospective cohort studies of national samples of CKD and HD pts, respectively. We evaluated 2973 pts with CKD Stages 3-5 from the US, Brazil, and France and 587 pts on HD from the US. Data were abstracted from medical records and patient-reported questionnaires. Pts were asked to identify the degree to which they were bothered by pruritus in the past 4 weeks, ranging from “not at all” to “extremely” (CKDopps patient questionnaire). Responses are presented graphically by CKD stage, and for US DOPPS (HD) pts for comparison. Generalized estimating equations (GEE) were used to identify predictors of moderate to extreme pruritus, adjusting for patient demographics, comorbidities, and country and accounting for facility clustering. Results: The percent of pts with moderate to extreme pruritus rose from 21% in Stage 3a to 29% in Stage 5 (p for trend = 0.25, accounting for country). Differences in the prevalence of pruritus between US, Brazil, and France were not significant after adjusting for patient characteristics. Moderate to extreme pruritus was more common in females (AOR = 1.35; 95% CI 1.10-1.6) and in patients with diabetes (AOR = 1.41; 1.11-1.80), lung disease (AOR = 1.42; 1.13-1.79), or psychiatric disease (AOR = 1.66; 1.32-2.10). Conclusions: The prevalence of pruritus was higher in CKD pts than reported for the general population, and its prevalence in advanced stages approaches that of the HD population. Studies are needed to evaluate the burden of pruritus in CKD on patient-reported outcomes, and to identify modifiable risk factors and effective treatments for pruritus. (Figure Presented).