Effects of Uremic Pruritus on Dermatological and Kidney Disease Quality of Life in Patients Receiving Hemodialysis

Abstract

Aim: This study was conducted in order to determine the dermatological and kidney disease quality of life of patients with uremic pruritus receiving hemodialysis treatment. Material and Methods: The present study was a descriptive study. The sample comprised 200 of HD patients. The participants were required to complete patient information form, 5-D-Itch scale, Dermatological Quality of Life Index (DLQI) and Kidney Disease Quality of Life Form (KDQOL-36) were used to collect the data of the study. Results: It was determined that the DLQI score average of the patients with pruritus was 11.57±4.74 and that the dermatological quality of life of 60.6% of the patients was largely or extremely affected. It was revealed that the average KDQOL-36 score of the patients with pruritus was 59.36±12.27, and their kidney disease quality of life was of moderate level. Pruritus severity explained a moderate amount of the variability of DLQL (crude R2 =.181) and KDQOL-36 (crude R2 =.184). Conclusion: It was determined that as the severity of uremic pruritus increased, DLQI and KDQO-36 decreased. Therefore, timely treatment, nursing care and counseling are recommended to monitor level of pruritus, dermatological and general quality of life to improve the quality of life in HD patients.

Keywords

• Dermatology quality of life
• general quality of life
• hemodialysis
• itch

Kaynakça

1. 1. İn H, Kılıç Akça N. Assessment of skin manifestations in patients undergoing hemodialysis. Journal of Nephrology Nursing. 2021;16(1):1-9.
2. 2. Adejumo O, Akinbodewa A, Alli O, Olatunji A, Ibukun I. Prevalence, pattern and association of pruritus with quality of life in chronic kidney disease patients attending kidney care center, Ondo City, Southwest Nigeria. Ethiopian Journal of Health Sciences. 2016; 26(6):549-554.
3. 3. Kılıç Akça N. Common skin problems in hemodialysis patients and nursing care. Journal of Nephrology Nursing. 2019;14(1):26-32.
4. 4. Rehman IU, Lai PS, Kun LS, Lee LH, Chan KG, Khan TM. Chronic kidney disease‐associated pruritus and quality of life in Malaysian patients undergoing hemodialysis. Therapeutic Apheresis and Dialysis. 2020;24(1):17-25.
5. 5. Rehman IU, Munib S, Ramadas A, Khan TM. Prevalence of chronic kidney disease-associated pruritus and association with sleep quality among hemodialysis patients in Pakistan. Plus One. 2018;13(11):1-9.
6. 6. Rehman IU, Khan TM. Effect of chronic kidney disease-associated pruritus on patients’ sleep quality, well-being, and its management. Progress in Microbes ve Molecular Biology. 2020;3(1);1-9.
7. 7. Blaha T, Nigwekar S, Combs S, Kaw U, Krishnappa V, Raina R. Dermatologic manifestations in end-stage renal disease. Hemodialysis International. 2019;23(1):3-18.
8. 8. Verduzco HA, Shirazian S. Chronic kidney disease-associated pruritus: new insights into diagnosis, pathogenesis, and management. Kidney International Reports. 2020;5(9):1387-1402.

9. 9. Kimata N, Fuller DS, Saito A, Akizawa T, Fukuhara S, Pisoni RL, et al. Pruritus in hemodialysis patients: Results from the Japanese Dialysis Outcomes and Practice Patterns Study (JDOPPS). Hemodialysis International. 2014;18(3):657-667.
10. 10. Küçükünal A, Altunay İK, Salman KE, Atış G. The relationship between uraemic pruritus and quality of life scores in hemodialysis patients. Turkderm-Arch Turk Dermatol Venerology. 2015;49(1):23-27.
11. 11. Yabacı S, Kılıç Akça N, Efe Arslan D. Cronic itch-stress vicious circle and nursing approach. ERÜ Sağlık Bilimleri Fakültesi Dergisi. 2019;6(2):26-34.
12. 12. Altınok Ersoy N, Akyar İ. Multidimensional pruritus assessment in hemodialysis patients. BMC Nephrology. 2019;20(1):1-7.
13. 13. Satti MZ, Arshad D, Javed H, Shahroz A, Tahir Z, Ahmed M, et al. Uremic pruritus: prevalence and impact on quality of life and depressive symptoms in hemodialysis patients. Cureus. 2019;11(7):e5178.
14. 14. Pisoni RL, Wikström B, Elder SJ, Akizawa T, Asano Y, Keen ML, et al. Pruritus in hemodialysis patients: international results from the dialysis outcomes and practice patterns study (DOPPS). Nephrology Dialysis Transplantation. 2006;21(12):3495-3505.
15. 15. Szepietowski JC, Balaskas E, Taube KM, Taberly A, Dupuy P. Quality of life in patients with uraemic xerosis and pruritus. Acta Dermato-Venereologica. 2011;91(3):313-317.
16. 16. Elman S, Hynan LS, Gabriel V, Mayo MJ. The 5‐D itch scale: a new measure of pruritus. British Journal of Dermatology. 2010;162(3):587-593.
17. 17. Altınok Ersoy N, Akyar İ. Validity and reliability of 5-D itch scale on chronic renal disease patients. ACU Sağlık Bil Derg. 2018;9(4):455-461.
18. 18. Finlay A, Khan G. Dermatology life quality index (DLQI)- a simple practical measure for routine clinical use. Clinical and Experimental Dermatology. 1994;19(3):210-216.
19. 19. Öztürkcan S, Ermertcan AT, Eser E, Turhan Şahin M. Cross-validation of the Turkish version of dermatology life quality index. International Journal of Dermatology. 2006;45(11):1300-1307.
20. 20. Hays RD, Kallich JD, Mapes DL, Coons SJ, Amin N, Carter WB, et al. Kidney Disease Quality of Life Short Form (KDQOL-SF TM), Version 1.3: A Manuel for use and scoring. P-7994, Santa Monica, CA, RAND, 1997.
21. 21. Yıldırım A, Ögütmen B, Bektas G, İsçi E, Mete M, Tolgay HI. Translation, cultural adaptation, initial reliability, and validation of the kidney disease and quality of life-short form (KDQOL-SF 1.3) in Turkey. Transplantation Proceedings. 2007;39(1):51-54.
22. 22. Özkan İ, Taylan S. Investigation of the relationship between pruritus and sleep and anxiety in hemodialysis patients. Journal of Nephrology Nursing. 2020;15(2):78-90
23. 23. Kılıç Akça N, Taşçı S. An important problem among hemodialysis patients: uremic pruritus and affecting factors. Turkish Journal of Nephrology. 2014;23(3):210-216.
24. 24. Hsu MC, Chen HW, Hwu YJ, Chanc CM, Liu CF. Effects of thermal therapy on uremic pruritus and biochemical parameters in patients having hemodialysis. Journal Of Advanced Nursing. 2009;65(11):2397-2408.
25. 25. Boonsiri M, Tangtrongsitthikul P, Hanthavichai S. Prevalence of skin conditions of monks in urban Bangkok temples. Journal of the Medical Association of Thailand. 2019;102(9):10-14.
26. 26. Edalat-Nejad M, Qlich-Khani M. Quality of life and sleep in hemodialysis patients. Saudi Journal of Kidney Diseases and Transplantation. 2013;24(3):514-519.
27. 27. Erturk IE, Arıcan O, Omurlu IK, Sut N. Effect of the pruritus on the quality of life: a preliminary study. Annals of Dermatology. 2012;24(4):406-412.
28. 28. İbrahim MK, Elshahid AR, El-Baz TZ, Elazab RM, Elhoseiny SA, Elsie ML. Impact of uraemic pruritus on quality of life among end-stage renal disease patients on dialysis. Journal of Clinical and Diagnostic Research. 2016;10(3):01-05.
29. 29. Weiss M, MettangT, Tschulena U, Weisshaar E. Health-related quality of life in hemodialysis patients suffering from chronic itch: results from gehis (German epidemiology hemodialysis itch study). Quality of Life Research. 2016;25(12):3097-3106.