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血液透析患者的尿毒症瘙痒及相关因素:一项多中心研究。

Uremic pruritus and associated factors in hemodialysis patients: A multi-center study.

作者信息

Ozen Nurten, Cinar Fatma Ilknur, Askin Dilek, Mut Dilek

机构信息

Department of Midwifery, Faculty of Health Sciences, Istinye University, Istanbul, Turkey.

Department of Internal Disease Nursing, University of Health Sciences, Gulhane School of Nursing, Ankara, Turkey.

出版信息

Kidney Res Clin Pract. 2018 Jun;37(2):138-147. doi: 10.23876/j.krcp.2018.37.2.138. Epub 2018 Jun 30.

Abstract

BACKGROUND

Uremic pruritus is a common and disturbing problem in hemodialysis patients. Although its pathogenesis is not completely understood, it is thought to be multifactorial. The aim of this study was to identify risk factors of uremic pruritus in hemodialysis patients.

METHODS

A total of 249 patients from four dialysis centers were included in this study. Data were collected using a questionnaire, the visual analogue scale, and the Hospital Anxiety and Depression Scale. We investigated whether socio-demographic and biochemical parameters were correlated to uremic pruritus.

RESULTS

Pruritus was present in 53.4% of the hemodialysis patients. The mean visual analogue scale severity was 6.47 ± 1.56. Patients with white blood cell (WBC) counts > 6.7 × 10/μL had 1.73 times (95% confidence interval [CI], 1.360-2.888; = 0.036) more pruritus than did those with WBC counts < 6.7 × 10/μL. Patients with dry skin were 0.2 times (95% CI, 0.070-0.182; = 0.028) more likely to suffer from very severe pruritus than were those with normal skin.

CONCLUSION

Uremic pruritus remains a serious problem in dialysis patients. The WBC level and presence of dry skin are thought to be among its causes. Therefore, data regarding the possible risk factors of uremic pruritus must be followed closely in patients at risk.

摘要

背景

尿毒症瘙痒是血液透析患者常见且令人困扰的问题。尽管其发病机制尚未完全明确,但被认为是多因素的。本研究旨在确定血液透析患者尿毒症瘙痒的危险因素。

方法

本研究纳入了来自四个透析中心的249名患者。通过问卷调查、视觉模拟量表和医院焦虑抑郁量表收集数据。我们调查了社会人口统计学和生化参数是否与尿毒症瘙痒相关。

结果

53.4%的血液透析患者存在瘙痒。视觉模拟量表的平均严重程度为6.47±1.56。白细胞(WBC)计数>6.7×10/μL的患者瘙痒发生率是WBC计数<6.7×10/μL患者的1.73倍(95%置信区间[CI],1.360 - 2.888;P = 0.036)。皮肤干燥的患者发生非常严重瘙痒的可能性是皮肤正常患者的0.2倍(95%CI,0.070 - 0.182;P = 0.028)。

结论

尿毒症瘙痒在透析患者中仍然是一个严重问题。白细胞水平和皮肤干燥被认为是其病因之一。因此,对于有风险的患者,必须密切关注有关尿毒症瘙痒可能危险因素的数据。

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