Huang Wen-Hung, Lin Jui-Hsiang, Weng Cheng-Hao, Hsu Ching-Wei, Yen Tzung-Hai
Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital, Linkou Medical Center, Taiwan, ROC.
Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.
Sci Rep. 2016 Aug 10;6:31168. doi: 10.1038/srep31168.
Uremic pruritus (UP), also known as chronic kidney disease-associated pruritus, is a common and disabling symptom in patients undergoing maintenance hemodialysis (MHD). The pathogenesis of UP is multifactorial and poorly understood. Outdoor air pollution has well-known effects on the health of patients with allergic diseases through an inflammatory process. Air pollution-induced inflammation could occur in the skin and aggravate skin symptoms such as pruritus or impair epidermal barrier function. To assess the role of air pollutants, and other clinical variables on uremic pruritus (UP) in HD patients, we recruited 866 patients on maintenance HD. We analyzed the following variables for association with UP: average previous 12-month and 24-month background concentrations for nitrogen dioxide (NO2) and carbon monoxide (CO), and suspended particulate matter of <2.5 μm (PM2.5). In a multivariate logistic regression, hemodialysis duration, serum ferritin levels, low-density lipoprotein levels, and environmental NO2/CO levels were positively associated with UP, and serum albumin levels were negatively associated with UP. This cross-sectional study showed that air pollutants such as NO2 and CO might be associated with UP in patients with MHD.
尿毒症瘙痒（UP），也称为慢性肾脏病相关性瘙痒，是维持性血液透析（MHD）患者中一种常见且使人丧失能力的症状。UP的发病机制是多因素的，目前了解甚少。室外空气污染通过炎症过程对过敏性疾病患者的健康有众所周知的影响。空气污染引起的炎症可能发生在皮肤中，加重瘙痒等皮肤症状或损害表皮屏障功能。为了评估空气污染物和其他临床变量对血液透析（HD）患者尿毒症瘙痒（UP）的作用，我们招募了866例维持性HD患者。我们分析了以下变量与UP的相关性：之前12个月和24个月二氧化氮（NO2）、一氧化碳（CO）以及小于2.5微米的悬浮颗粒物（PM2.5）的平均背景浓度。在多因素逻辑回归分析中，血液透析时长、血清铁蛋白水平、低密度脂蛋白水平以及环境中NO2/CO水平与UP呈正相关，而血清白蛋白水平与UP呈负相关。这项横断面研究表明，NO2和CO等空气污染物可能与MHD患者的UP有关。
