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慢性肾衰竭患者瘙痒的临床特征及危险因素

Clinical features and risk factors of pruritus in patients with chronic renal failure.

作者信息

Hu Tinghai, Wang Bo, Liao Xiaohui, Wang Shuxiang

机构信息

Department of Nephrology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, Sichuan 400010, P.R. China.

Department of Endocrinology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, Sichuan 400010, P.R. China.

出版信息

Exp Ther Med. 2019 Aug;18(2):964-971. doi: 10.3892/etm.2019.7588. Epub 2019 May 16.

Abstract

Dermatological manifestations are common in systemic diseases, such as chronic kidney disease. The present study investigated the clinical features and possible influencing factors of pruritus in patients with chronic renal failure (CRF). A total of 382 inpatients were enrolled from the Department of Nephrology at The Second Affiliated Hospital of Chongqing Medical University. A total of 138 subjects were hemodialysis patients, 41 were peritoneal dialysis patients, and 203 were chronic renal failure patients. The patients' clinical performance was observed, and the data was recorded for analysis. The prevalence of pruritus in hemodialysis patients was greater than that in peritoneal dialysis patients. A total of 187 patients were accompanied by xerodermia and 109 patients had pruritus at the same time. With effective and regular dialysis, pruritus could be alleviated in 40% of patients. The intensity of pruritus in the enrolled patients ranged from mild itching to irritability during day and night periods. Moreover, pruritus was intermittent or persistent, and/or limited to generalized. Following treatment, 35% of patients had poor results. A significant difference was noted in the levels of serum urea nitrogen, creatinine, serum phosphorus, calcium × phosphorus, and parathyroid hormone (PTH) between patients with pruritus and non-pruritus. Xerodermia is a common skin manifestation in patients with chronic renal failure and is associated with the occurrence of pruritus. Local cold and heat stimulation can relieve pruritus to some extent, and adequate hemodialysis can also relieve itching.

摘要

皮肤表现常见于全身性疾病,如慢性肾脏病。本研究调查了慢性肾衰竭(CRF)患者瘙痒的临床特征及可能的影响因素。重庆医科大学附属第二医院肾内科共纳入382例住院患者。其中血液透析患者138例,腹膜透析患者41例,慢性肾衰竭患者203例。观察患者的临床表现并记录数据进行分析。血液透析患者瘙痒的患病率高于腹膜透析患者。共有187例患者伴有皮肤干燥,其中109例同时伴有瘙痒。通过有效且规律的透析,40%的患者瘙痒可得到缓解。纳入患者的瘙痒程度从轻度瘙痒到日夜烦躁不等。此外,瘙痒呈间歇性或持续性,和/或局限于全身性。治疗后,35%的患者效果不佳。瘙痒患者与无瘙痒患者在血清尿素氮、肌酐、血清磷、钙×磷及甲状旁腺激素(PTH)水平上存在显著差异。皮肤干燥是慢性肾衰竭患者常见的皮肤表现,且与瘙痒的发生有关。局部冷、热刺激可在一定程度上缓解瘙痒,充分的血液透析也可减轻瘙痒。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc9c/6639943/926587a2fb7c/etm-18-02-0964-g00.jpg

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