Department of Internal medicine, division of general internal medicaine and nephrology, Robert-Bosch-Hosptial, DR-70376 Stuttgart, Germany.
Acta Derm Venereol. 2019 May 1;99(6):524-529. doi: 10.2340/00015555-3128.
Pruritus, impaired mental health and inflammation contribute to morbidity in end-stage renal disease. There are no studies on all 3 conditions. We therefore obtained inflammatory parameter data (C-reactive protein and interleukin-6), pruritus data and psychological test data (36-Item Short-Form Health Survey, "Allgemeine Depressionsskala" and Toronto Alexithymia Scale-20) for 19 dialysis patients with pruritus, 20 dialysis patients without pruritus and 15 healthy controls. Non-parametric hierarchical clustering revealed 3 clusters of parameters: one mainly driven by pruritus scores (chronic kidney disease-associated pruritus cluster), one by mental health scores (mental health cluster) and one by inflammatory parameters (inflammatory cluster). Factor analysis showed strong associations (mental health cluster/chronic kidney disease-associated pruritus cluster, r=-0.49; mental health cluster/inflammatory cluster, r=-0.52; inflammatory cluster/chronic kidney disease-associated pruritus cluster, r=0.48). For the first time, complete correlations between inflammation, mental health and pruritus in dialysis patients have been established. As all 3 conditions are associated with mortality, knowledge about their interdependence helps to understand end-stage renal disease pathophysiology.
瘙痒、心理健康受损和炎症都会导致终末期肾病患者的发病率增加。目前尚无针对这三种情况的研究。因此，我们为 19 名有瘙痒症状的透析患者、20 名无瘙痒症状的透析患者和 15 名健康对照者获取了炎症参数数据（C 反应蛋白和白细胞介素-6）、瘙痒数据和心理测试数据（36 项简短健康调查、“一般抑郁量表”和多伦多述情障碍量表-20）。非参数层次聚类揭示了 3 组参数：一组主要由瘙痒评分驱动（慢性肾脏病相关瘙痒组），一组由心理健康评分驱动（心理健康组），一组由炎症参数驱动（炎症组）。因子分析显示了强相关性（心理健康组/慢性肾脏病相关瘙痒组，r=-0.49；心理健康组/炎症组，r=-0.52；炎症组/慢性肾脏病相关瘙痒组，r=0.48）。这是首次在透析患者中建立了炎症、心理健康和瘙痒之间的完全相关性。由于这三种情况都与死亡率相关，因此了解它们之间的相互关系有助于理解终末期肾病的病理生理学。
