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

• Published in: Quality of life research Vol. 21; no. 4; pp. 603 - 612
• Main Authors: Lopes, Gildete Barreto, Nogueira, Fernanda Conceição Pereira, de Souza, Milena Reis, Penalva, Maria Auxiliadora, de Amorim, Josete Leão, Pisoni, Ronald L., Robinson, Bruce M., Lopes, Antonio Alberto
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer 01.05.2012; Springer Netherlands; Springer Nature B.V
• Subjects: Adult; Brazil; Calcium; CLINICAL AND POLICY APPLICATIONS; Cross-Sectional Studies; Data collection; Depression - complications; Depressive disorders; Dialysis; Disease models; Female; Hemodialysis; Humans; Kidney diseases; Kidney Diseases - complications; Kidney Diseases - therapy; Male; Medicine; Medicine & Public Health; Mental depression; Middle Aged; Modeling; Nephrology; Pruritus; Pruritus - complications; Pruritus - psychology; Public Health; Quality of life; Quality of Life - psychology; Quality of Life Research; Renal Dialysis; Restless legs syndrome; Skin; Skin diseases; Sleep; Sleep disorders; Sleep Wake Disorders - complications; Sociology; Surveys and Questionnaires; Symptoms; Brazil; Salvador Brazil; Itch; Sleep; Hemodialysis; Depression; Dry skin; Xerosis; Pruritus; Quality of life
• ISSN: 0962-9343; 1573-2649
• DOI: 10.1007/s11136-011-9964-x

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.