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腹膜透析患者尿毒症瘙痒的相关因素

Factors Associated with Uremic Pruritus in Patients Undergoing Peritoneal Dialysis.

作者信息

Minato Saori, Hirai Keiji, Morino Junki, Kaneko Shohei, Yanai Katsunori, Mutsuyoshi Yuko, Ishii Hiroki, Matsuyama Momoko, Kitano Taisuke, Shindo Mitsutoshi, Aomatsu Akinori, Miyazawa Haruhisa, Ito Kiyonori, Ueda Yuichiro, Hoshino Taro, Ookawara Susumu, Morishita Yoshiyuki

机构信息

Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.

出版信息

Int J Nephrol Renovasc Dis. 2020 Jan 14;13:1-9. doi: 10.2147/IJNRD.S224871. eCollection 2020.

Abstract

AIM

The aim of this study was to investigate different intensities of uremic pruritus in the daytime and nighttime, as well as contributing factors, in patients undergoing peritoneal dialysis (PD).

METHODS

A total of 46 patients (31 males, 15 females) with a mean age of 59.4±14.7 years and mean PD vintage of 29.2±25.2 months were enrolled in this single-center, prospective, cross-sectional study. The intensity of uremic pruritus in the daytime and nighttime was assessed using a visual analog scale (VAS). The relationships between intensity and various clinical and laboratory parameters were analyzed using multiple linear regression analyses.

RESULTS

The most common site of uremic pruritus was on the back (70%), followed by lower limbs (67%), chest and abdomen (59%), upper limbs (28%), and head and neck (22%). Mean VAS scores were higher in the nighttime compared with the daytime (4.5±3.3 vs. 3.5±2.7, =0.02). Only male sex was correlated with higher uremic pruritus intensity in the daytime (standard coefficient [β]=0.310, =0.036). PD vintage (β=0.415, =0.004) and topical medicines, including moisturizer and topical corticosteroid use (β=0.345, =0.019), were independently correlated with higher uremic pruritus intensity in the nighttime.

CONCLUSION

Uremic pruritus intensity was greater in the nighttime than in the daytime in PD patients. Male sex was associated with higher uremic pruritus intensity in the daytime, whereas PD vintage and topical medicine use were associated with higher uremic pruritus intensity in the nighttime.

摘要

目的

本研究旨在调查接受腹膜透析(PD)的患者白天和夜间不同强度的尿毒症瘙痒及其相关因素。

方法

本单中心、前瞻性、横断面研究共纳入46例患者(男性31例,女性15例),平均年龄59.4±14.7岁,平均腹膜透析时间29.2±25.2个月。使用视觉模拟量表(VAS)评估白天和夜间尿毒症瘙痒的强度。采用多元线性回归分析强度与各种临床和实验室参数之间的关系。

结果

尿毒症瘙痒最常见的部位是背部(70%),其次是下肢(67%)、胸部和腹部(59%)、上肢(28%)以及头颈部(22%)。夜间的平均VAS评分高于白天(4.5±3.3对3.5±2.7,P=0.02)。仅男性与白天较高的尿毒症瘙痒强度相关(标准系数[β]=0.310,P=0.036)。腹膜透析时间(β=0.415,P=0.004)以及局部用药,包括使用保湿剂和局部皮质类固醇(β=0.345,P=0.019)与夜间较高的尿毒症瘙痒强度独立相关。

结论

腹膜透析患者夜间的尿毒症瘙痒强度高于白天。男性与白天较高的尿毒症瘙痒强度相关,而腹膜透析时间和局部用药与夜间较高的尿毒症瘙痒强度相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee09/6969704/e1fe47585791/IJNRD-13-1-g0001.jpg

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