Li Jianying, Guo Qunying, Lin Jianxiong, Yi Chunyan, Yang Xiao, Yu Xueqing
Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Key Laboratory of Nephrology, Ministry of Health, China.
Intern Med. 2015;54(22):2827-33. doi: 10.2169/internalmedicine.54.4516. Epub 2015 Nov 15.
Uraemic pruritus is a distressing symptom that has a negative impact on the quality of life for dialysis patients. The pathophysiology of pruritus in peritoneal dialysis (PD) patients is still poorly understood. The present study aims to investigate the prevalence and related risk factors of pruritus in continuous ambulatory peritoneal dialysis (CAPD) patients.
In total, 362 CAPD cases were investigated from January 2012 to April 2013. Pruritus was assessed by visual analogue scale.
The prevalence of severe pruritus and mild to moderate pruritus was 12.7% and 52.5%, respectively. The patients with severe pruritus had the longest duration of PD (p<0.001), Pittsburgh Sleep Quality Index (PSQI) score (p<0.001), Beck Depression Inventory (BDI) score (p=0.003), intact parathyroid hormone (iPTH) level (p=0.009), and the lowest Medical Outcomes Short Form 36 Health Survey, Physical Component Score (SF-36 PCS) (p<0.001) among the three groups. The patients with mild to moderate pruritus had a significantly higher iPTH level (p=0.004) compared with the patients without pruritus. A multivariate logistic regression for pruritus showed that higher PSQI score [odds ratio (OR)=1.305, p=0.001], higher BDI score (OR=1.429, p=0.002), longer vintage (OR=1.039, p=0.004), and higher iPTH level (OR=1.317, p=0.014) were independently associated with pruritus.
The prevalence of uraemic pruritus was 65.2% in CAPD patients. Sleep disorder, depression, longer vintage, and a higher iPTH level were independent associated factors for pruritus in CAPD patients.
尿毒症瘙痒是一种令人痛苦的症状，对透析患者的生活质量有负面影响。腹膜透析（PD）患者瘙痒的病理生理学仍了解甚少。本研究旨在调查持续性非卧床腹膜透析（CAPD）患者瘙痒的患病率及相关危险因素。
2012年1月至2013年4月共调查了362例CAPD病例。采用视觉模拟量表评估瘙痒情况。
重度瘙痒和轻至中度瘙痒的患病率分别为12.7%和52.5%。重度瘙痒患者的腹膜透析时间最长（p<0.001）、匹兹堡睡眠质量指数（PSQI）评分（p<0.001）、贝克抑郁量表（BDI）评分（p=0.003）、全段甲状旁腺激素（iPTH）水平（p=0.009），且在三组中其简明健康调查量表36项健康调查的生理健康分量表（SF-36 PCS）得分最低（p<0.001）。与无瘙痒患者相比，轻至中度瘙痒患者的iPTH水平显著更高（p=0.004）。瘙痒的多因素逻辑回归分析显示，较高的PSQI评分[比值比（OR）=1.305，p=0.001]、较高的BDI评分（OR=1.429，p=0.002）、较长的透析龄（OR=1.039，p=0.004）和较高的iPTH水平（OR=1.317，p=0.014）与瘙痒独立相关。
CAPD患者中尿毒症瘙痒的患病率为65.2%。睡眠障碍、抑郁、较长的透析龄和较高的iPTH水平是CAPD患者瘙痒的独立相关因素。
