Article Sidebar
Downloads
Metrics
Main Article Content
Abstract
Introduction: Chronic kidney disease-pruritus is the sensation of itching related to the disease without another disease justifying it. Although its prevalence may have decreased, it still persists and is underdiagnosed.
Objective: To analyze the knowledge and usual practice of the nursing staff in our unit on the management of pruritus.
Material and Method: We conducted a descriptive, single-center study in March 2023 using a self-designed survey on the degree of knowledge and usual practice of the nursing staff in our nephrology unit regarding pruritus.
Results: 24 surveys (96% participation): 62.5% women with an age of 43.8±11.8 and 14.2±11.1 years of working experience.
A total of 41.6% (n=10) adequately estimated the prevalence of pruritus in our center. A total of 78% (n=21) diagnosed only if the patient reported it, while 50% (n=12) did not use specific assessment scales.
The simple visual analog scale (VAS) 21% (n=5) and the verbal numerical scale of worst itch (WI-NRS) 21% (n=5) were the most widely used. A total of 92% (n=22) and 71% (n=17) had knowledge of the main hygienic-dietary advice and possible causes of pruritus. All respondents considered that chronic kidney disease-related pruritus damaged the patient's quality of life and considered it useful to receive educational training.
Conclusiones: The nursing staff have adequate knowledge about chronic kidney disease- related pruritus. A proactive attitude towards its diagnosis and greater use of specific questionnaires are aspects to improve in our routine clinical practice.
Keywords
Article Details
Copyright (c) 2025 Ariadna Morera Mas, Vicent Esteve Simó, Jorge Alfonzo Juliá, Javier Gutiérrez de la Iglesia, Elisabeth González Lao, Sandra Rubio Paez, Manel Ramírez de Arellano Serna
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Author copyright notice
© Authors grant the publisher the non-exclusive licence to publish the work and consent to its use and distribution under the Creative Commons Attribution - NonCommercial 4.0 International (CC BY-NC 4.0) licence. Read the licensing information and the legal text here. This must be expressly stated wherever necessary.
References
- Agarwal P, Garg V, Karagaiah P, Szepietowski JC, Grabbe S, Goldust M. Chronic kidney disease-associated pruritus. Toxins (Basel). 2021;13(8). DOI: https://doi.org/10.3390/toxins13080527
- Narita I, Iguchi S, Omori K, Gejyo F. Uremic pruritus in chronic hemodialysis patients. J Nephrol. 2008;21(2):161–5.
- Kim D, Pollock C. Epidemiology and burden of chronic kidney disease-associated pruritus. Clin Kidney J [Internet]. 2021 Dec 24 [cited 2022 May 8];14(Suppl 3):i1–7. Available at: https://pubmed.ncbi.nlm.nih.gov/34987777/. DOI: https://doi.org/10.1093/ckj/sfab142
- Lipman ZM, Paramasivam V, Yosipovitch G, Germain MJ. Clinical management of chronic kidney disease-associated pruritus: current treatment options and future approaches. Clin Kidney J [Internet]. 2021;[cited 2022 May 8];14(Suppl 3):i16–22. Available at: https://pubmed.ncbi.nlm.nih.gov/34987779/. DOI: https://doi.org/10.1093/ckj/sfab167
- Manenti L, Leuci E. Do you feel itchy? A guide towards diagnosis and measurement of chronic kidney disease-associated pruritus in dialysis patients. Clin Kidney J [Internet]. 2021 [cited 2022 May 8];14(Suppl 3):i8–15. Available at: https://pubmed.ncbi.nlm.nih.gov/34987778/. DOI: https://doi.org/10.1093/ckj/sfab143
- Nair D, Finkelstein FO. Pruritus as a Patient-Reported Primary Trial End Point in Hemodialysis: Evaluation and Implications. Am J Kidney Dis [Internet]. 2020 [consultado 8 May 2022];76(1):148–51. Available at: https://www.ajkd.org/article/S0272-6386(20)30497-2/fulltext DOI: https://doi.org/10.1053/j.ajkd.2020.01.002
- Elke W, Uwe G, Jörg K, Masutaka F, Hidehisa S, Gil Y. Questionnaires to assess chronic itch: A consensus paper of the special interest group of the international forum on the study of itch. Acta Derm Venereol. 2012;92(5):493–6. DOI: https://doi.org/10.2340/00015555-1402
- Verduzco HA, Shirazian S. CKD-Associated Pruritus: New Insights Into Diagnosis, Pathogenesis, and Management. Kidney Int reports [Internet]. 2020; 5(9):1387–402. Available at: https://pubmed.ncbi.nlm.nih.gov/32954065/. DOI: https://doi.org/10.1016/j.ekir.2020.04.027
- Mathur VS, Lindberg J, Germain M, Block G, Tumlin J, Smith M, et al. A longitudinal study of uremic pruritus in hemodialysis patients. Clin J Am Soc Nephrol. 2010 5(8):1410–9. DOI: https://doi.org/10.2215/CJN.00100110
- Hussien H, Apetrii M, Covic A. Health-related quality of life in patients with chronic kidney disease. Expert Rev Pharmacoeconomics Outcomes Res. 2021;21(1):43–54. DOI: https://doi.org/10.1080/14737167.2021.1854091
- Vernon M, Ständer S, Munera C, Spencer RH, Menzaghi F. Clinically meaningful change in itch intensity scores: An evaluation in patients with chronic kidney disease–associated pruritus. J Am Acad Dermatol. 2021;84(4):1132–4. DOI: https://doi.org/10.1016/j.jaad.2020.06.991
- Kalantar-Zadeh K, Lockwood MB, Rhee CM, Tantisattamo E, Andreoli S, Balducci A, et al. Patient-centred approaches for the management of unpleasant symptoms in kidney disease. Nat Rev Nephrol [Internet]. 2022;18(3):185–98. Available at: https://pubmed.ncbi.nlm.nih.gov/34980890/. DOI: https://doi.org/10.1038/s41581-021-00518-z
- Simonsen E, Komenda P, Lerner B, Askin N, Bohm C, Shaw J, et al. Treatment of Uremic Pruritus: A Systematic Review. Am J Kidney Dis. 2017;70(5):638–55. DOI: https://doi.org/10.1053/j.ajkd.2017.05.018
- Trachtenberg AJ, Collister D, Rigatto C. Recent advances in the treatment of uremic pruritus. Curr Opin Nephrol Hypertens. 2020;29(5):465–70. DOI: https://doi.org/10.1097/MNH.0000000000000625
References
Agarwal P, Garg V, Karagaiah P, Szepietowski JC, Grabbe S, Goldust M. Chronic kidney disease-associated pruritus. Toxins (Basel). 2021;13(8). DOI: https://doi.org/10.3390/toxins13080527
Narita I, Iguchi S, Omori K, Gejyo F. Uremic pruritus in chronic hemodialysis patients. J Nephrol. 2008;21(2):161–5.
Kim D, Pollock C. Epidemiology and burden of chronic kidney disease-associated pruritus. Clin Kidney J [Internet]. 2021 Dec 24 [cited 2022 May 8];14(Suppl 3):i1–7. Available at: https://pubmed.ncbi.nlm.nih.gov/34987777/. DOI: https://doi.org/10.1093/ckj/sfab142
Lipman ZM, Paramasivam V, Yosipovitch G, Germain MJ. Clinical management of chronic kidney disease-associated pruritus: current treatment options and future approaches. Clin Kidney J [Internet]. 2021;[cited 2022 May 8];14(Suppl 3):i16–22. Available at: https://pubmed.ncbi.nlm.nih.gov/34987779/. DOI: https://doi.org/10.1093/ckj/sfab167
Manenti L, Leuci E. Do you feel itchy? A guide towards diagnosis and measurement of chronic kidney disease-associated pruritus in dialysis patients. Clin Kidney J [Internet]. 2021 [cited 2022 May 8];14(Suppl 3):i8–15. Available at: https://pubmed.ncbi.nlm.nih.gov/34987778/. DOI: https://doi.org/10.1093/ckj/sfab143
Nair D, Finkelstein FO. Pruritus as a Patient-Reported Primary Trial End Point in Hemodialysis: Evaluation and Implications. Am J Kidney Dis [Internet]. 2020 [consultado 8 May 2022];76(1):148–51. Available at: https://www.ajkd.org/article/S0272-6386(20)30497-2/fulltext DOI: https://doi.org/10.1053/j.ajkd.2020.01.002
Elke W, Uwe G, Jörg K, Masutaka F, Hidehisa S, Gil Y. Questionnaires to assess chronic itch: A consensus paper of the special interest group of the international forum on the study of itch. Acta Derm Venereol. 2012;92(5):493–6. DOI: https://doi.org/10.2340/00015555-1402
Verduzco HA, Shirazian S. CKD-Associated Pruritus: New Insights Into Diagnosis, Pathogenesis, and Management. Kidney Int reports [Internet]. 2020; 5(9):1387–402. Available at: https://pubmed.ncbi.nlm.nih.gov/32954065/. DOI: https://doi.org/10.1016/j.ekir.2020.04.027
Mathur VS, Lindberg J, Germain M, Block G, Tumlin J, Smith M, et al. A longitudinal study of uremic pruritus in hemodialysis patients. Clin J Am Soc Nephrol. 2010 5(8):1410–9. DOI: https://doi.org/10.2215/CJN.00100110
Hussien H, Apetrii M, Covic A. Health-related quality of life in patients with chronic kidney disease. Expert Rev Pharmacoeconomics Outcomes Res. 2021;21(1):43–54. DOI: https://doi.org/10.1080/14737167.2021.1854091
Vernon M, Ständer S, Munera C, Spencer RH, Menzaghi F. Clinically meaningful change in itch intensity scores: An evaluation in patients with chronic kidney disease–associated pruritus. J Am Acad Dermatol. 2021;84(4):1132–4. DOI: https://doi.org/10.1016/j.jaad.2020.06.991
Kalantar-Zadeh K, Lockwood MB, Rhee CM, Tantisattamo E, Andreoli S, Balducci A, et al. Patient-centred approaches for the management of unpleasant symptoms in kidney disease. Nat Rev Nephrol [Internet]. 2022;18(3):185–98. Available at: https://pubmed.ncbi.nlm.nih.gov/34980890/. DOI: https://doi.org/10.1038/s41581-021-00518-z
Simonsen E, Komenda P, Lerner B, Askin N, Bohm C, Shaw J, et al. Treatment of Uremic Pruritus: A Systematic Review. Am J Kidney Dis. 2017;70(5):638–55. DOI: https://doi.org/10.1053/j.ajkd.2017.05.018
Trachtenberg AJ, Collister D, Rigatto C. Recent advances in the treatment of uremic pruritus. Curr Opin Nephrol Hypertens. 2020;29(5):465–70. DOI: https://doi.org/10.1097/MNH.0000000000000625