Department of Nephrology, Zonguldak Atatürk Government Hospital, Zonguldak, Turkey.
Ren Fail. 2012;34(10):1264-9. doi: 10.3109/0886022X.2011.560401. Epub 2011 Mar 4.
Uremic pruritus (UP) remains a frequent problem in hemodialysis (HD) patients and is related to mortality. Poor glycemic control, as evaluated by hemoglobin A1c (HbA1c), is also associated with morbidity and mortality in HD patients. In this study, we investigated the relationship between UP and HbA1c in HD patients.
Sociodemographic, clinical, and laboratory variables, depressive symptoms, and health-related quality of life were assessed. Severity of UP was evaluated by visual analogue scale (VAS). The scale consisted of a 10 cm horizontal line marked from 0 (denoting no itch) to 10 (denoting worst possible imaginable itch).
Totally, 75 patients (male/female, 41/34; diabetic/nondiabetic, 29/46; age, 51.9 ± 13.5 years) were included. The VAS pruritus score was higher in diabetic patients compared with nondiabetic patients (4.7 ± 2.8 vs. 3.0 ± 1.0, p : 0.015). In diabetics, VAS pruritus score was independently related with calcium-phosphorus product (β : +0.637, p < 0.0001), intact parathyroid hormone (β : +0.343, p : 0.017), HbA1c (β : +0.310, p : 0.027), and Beck depression score (β : +0.474, p : 0.002). In nondiabetics, VAS pruritus score was independently related with calcium-phosphorus product (β : +0.486, p : 0.004), intact parathyroid hormone (β : +0.302, p : 0.041), and HbA1c (β : +0.341, p : 0.033). In the whole patient group, VAS pruritus score was independently related with calcium-phosphorus product (β : +0.372, p : 0.001), intact parathyroid hormone (β : +0.241, p : 0.008), HbA1c (β : +0.227, p : 0.031), and Beck depression score (β : +0.298, p : 0.003).
In both diabetic and nondiabetic patients, HbA1c is closely related with pruritus in HD patients.
尿毒症瘙痒(UP)仍然是血液透析(HD)患者的常见问题,与死亡率有关。糖化血红蛋白(HbA1c)评估的血糖控制不佳也与 HD 患者的发病率和死亡率有关。在这项研究中,我们调查了 UP 与 HD 患者的 HbA1c 之间的关系。
评估了社会人口统计学、临床和实验室变量、抑郁症状和健康相关生活质量。通过视觉模拟量表(VAS)评估 UP 的严重程度。该量表由一条 10 厘米长的水平线组成,标记范围从 0(表示无瘙痒)到 10(表示可想象到的最严重瘙痒)。
共纳入 75 例患者(男/女,41/34;糖尿病/非糖尿病,29/46;年龄,51.9±13.5 岁)。与非糖尿病患者相比,糖尿病患者的 VAS 瘙痒评分更高(4.7±2.8 比 3.0±1.0,p:0.015)。在糖尿病患者中,VAS 瘙痒评分与钙磷乘积(β:+0.637,p<0.0001)、全段甲状旁腺激素(β:+0.343,p:0.017)、HbA1c(β:+0.310,p:0.027)和贝克抑郁评分(β:+0.474,p:0.002)独立相关。在非糖尿病患者中,VAS 瘙痒评分与钙磷乘积(β:+0.486,p:0.004)、全段甲状旁腺激素(β:+0.302,p:0.041)和 HbA1c(β:+0.341,p:0.033)独立相关。在整个患者组中,VAS 瘙痒评分与钙磷乘积(β:+0.372,p:0.001)、全段甲状旁腺激素(β:+0.241,p:0.008)、HbA1c(β:+0.227,p:0.031)和贝克抑郁评分(β:+0.298,p:0.003)独立相关。
在糖尿病和非糖尿病患者中,HbA1c 与 HD 患者的瘙痒密切相关。