Gatmiri Seyed Mansour, Mahdavi-Mazdeh Mitra, Lessan-Pezeshki Mahboob, Abbasi Mohammadreza
Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Acta Med Iran. 2013 Aug 7;51(7):477-81.
Pruritus is a common and bothersome problem among uremic patients which negatively affects life quality and prognosis of the patient. Various factors are known to be involved in the development of pruritus. The aim of this study was to assess the frequency and the factors which may have relationship with uremic pruritus, especially bone mineral metabolism indicators. Current cross-sectional study was done on 99 hemodialysis patients. Having pruritus, its duration, severity and correlation with patient's laboratory data was evaluated. For each patient a questionnaire was filled. The mean age of patients was 55.9±15.4 (23-87) years and 35.7% were female. They were on hemodialysis for 74.79±75.04 months. Frequency of pruritus was 58.6% (58 patients). Considering the severity, 16.2% suffered from severe pruritus, measured by visual analogue scale (VAS). Pruritus was more common in those on dialysis for more than 2 years (0.014). 82.8% of those with VAS of less than 3, in comparison with 37.5% of those with VAS of greater than 7, had no complaint of awakening due to pruritus. The frequency of pruritus and its severity was more in patients with higher serum phosphorus level (P=0.048). It seems that phosphate control which is not mainly attributed to dialysis adequacy and efficiency, needs more attention not only by medical team but also by patient. Decreasing the phosphate content of regimen may be cheap and helpful modality in pruritus management.
瘙痒是尿毒症患者常见且令人困扰的问题，会对患者的生活质量和预后产生负面影响。已知多种因素与瘙痒的发生有关。本研究的目的是评估与尿毒症瘙痒相关的频率及因素，尤其是骨矿物质代谢指标。对99例血液透析患者进行了当前的横断面研究。评估了患者是否有瘙痒、瘙痒持续时间、严重程度及其与患者实验室数据的相关性。为每位患者填写了一份问卷。患者的平均年龄为55.9±15.4（23 - 87）岁，女性占35.7%。他们接受血液透析的时间为74.79±75.04个月。瘙痒的发生率为58.6%（58例患者）。根据严重程度，通过视觉模拟量表（VAS）测量，16.2%的患者患有严重瘙痒。瘙痒在透析超过2年的患者中更为常见（P = 0.014）。VAS评分小于3的患者中，82.8%没有因瘙痒而醒来的主诉，而VAS评分大于7的患者中这一比例为37.5%。血清磷水平较高的患者瘙痒的发生率及其严重程度更高（P = 0.048）。似乎不仅医疗团队，患者自身也需要更多关注磷的控制，而这并不主要归因于透析充分性和效率。降低治疗方案中的磷含量可能是管理瘙痒的一种廉价且有效的方式。
