Multidimensional pruritus assessment in hemodialysis patients

BackgroundPruritus is a distressing, life-limiting symptom in chronic renal failure, affecting 40% of patients. This study aimed to determine uremic pruritus prevalence and investigate the multidimensional impact on hemodialysis patients.MethodsThis descriptive study was performed between March and June 2016. The study included 181 patients undergoing hemodialysis session, who reported pruritus in the prior month. Data were collected using the 5-D Itch Scale, which assesses pruritus based on 5 dimensions, i.e., degree, duration, direction, disability, and distribution, with a total score ranging from 5 (no itching) to 25 (maximum severity).ResultsPruritus prevalence was 49.3%. Patients had a mean score of 13.974.11 (moderate severity). The daily duration was 6-12h (40.3%), with direction a little bit better but still present (38.7%) and distribution on the back, upper arms, chest, and abdomen. Patients sleep, social life/leisure time, housework and errand were impacted occasionally. The score was higher in patients aged 65years, those on hemodialysis for 15 or more years, and those undergoing afternoon hemodialysis. The duration of itching was significantly shorter in employed patients.ConclusionAssessment and management of itching symptoms in chronic renal failure are a clinical priority both for patients and for health care professionals. The results of this study highlight the importance of multidimensional assessment and support the need for development of standardized and patient-specific symptom management.