Dar Nasser Rashid, Akhter Ayesha
Department of Dermatology, Combined Military Hospital, Bahawalpur Cantt.
J Coll Physicians Surg Pak. 2006 Feb;16(2):94-6.
To document various characteristics of uremic pruritus in patients undergoing haemodialysis.
Case series.
This study was carried out at Sindh Institute of Urology, Karachi, and Departments of Dermatology and Medicine, PNS Shifa, Karachi, over a period of 3 months.
One hundred patients of end stage renal disease undergoing haemodialysis were studied. Characteristics of pruritus like occurrence, duration, appearance, intensity, distribution, areas of maximum intensity, relationship to HCV status, effect on mood and sleep were documented. Effect of rest, dry skin, heat, sweat, clothing, cold, tiredness, dialysis, medications, application of lubricants and association of pruritus with different laboratory parameters was also noted. A comprehensive proforma was used to collect the data.
Pruritus appeared within 2-3 months of start of dialysis in 75%. It occurred daily in 83%, weekly in 11% and monthly in 6%. It was intermittent in 45%, all day in 32%, and exacerbated at night in 23%. It was mild in 48%, moderate in 17%, severe in 27% and intractable in 8%. Areas of maximum intensity were legs (60%) and back (30%), 55% had sleep problems, 21% became agitated, while 11% became depressed. Dry skin and cold environment exacerbated while rest and hot environment ameliorated pruritus. Patients with pruritus did not differ from those without it with regard to laboratory parameters or use of medication.
This study gives us a comprehensive characterization of uremic pruritus which may be a useful guideline for the treating physician.
记录接受血液透析患者的尿毒症瘙痒的各种特征。
病例系列研究。
本研究在卡拉奇的信德泌尿学研究所、卡拉奇海军医学中心皮肤病学和医学系进行，为期3个月。
对100例接受血液透析的终末期肾病患者进行研究。记录瘙痒的特征，如发生情况、持续时间、外观、强度、分布、最严重的部位、与丙型肝炎病毒状态的关系、对情绪和睡眠的影响。还记录了休息、皮肤干燥、热、出汗、衣物、寒冷、疲劳、透析、药物、润滑剂应用以及瘙痒与不同实验室参数的关联的影响。使用综合表格收集数据。
75%的患者在开始透析后2 - 3个月内出现瘙痒。83%的患者每天发作，11%每周发作，6%每月发作。45%为间歇性发作，32%整天发作，23%在夜间加重。48%为轻度，17%为中度，27%为重度，8%为顽固性瘙痒。最严重的部位是腿部（60%）和背部（30%），55%有睡眠问题，21%变得烦躁，11%变得抑郁。皮肤干燥和寒冷环境会加重瘙痒，而休息和炎热环境会缓解瘙痒。有瘙痒的患者与无瘙痒的患者在实验室参数或药物使用方面没有差异。
本研究为我们提供了尿毒症瘙痒的全面特征，这可能对治疗医生是一个有用的指导。
