Kossuth-Cabrejos Stefano, Gavino-Gutiérrez Arquímedes M, Silva-Caso Wilmer
Dermatologist, Universidad Nacional Mayor de San Marcos.
Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas (UPC).
Dermatol Reports. 2020 Jun 23;12(1):8310. doi: 10.4081/dr.2020.8310. eCollection 2020 Jun 25.
The objective of the study is to analyze the factors associated with the severity of pruritus in patients with terminal chronic kidney disease undergoing hemodialysis. The methodology used is based on a cross-sectional study in patients receiving hemodialysis at the Centro Nacional de Salud Renal. Severe pruritus was defined as a score on the visual analogue scale greater than or equal to 7, and the strength of association with the possible risk factors was assessed by calculating prevalence ratios. Regarding the results, 264 patients were included, 59.9% were male, with a mean time on hemodialysis of 10.26 ± 7.14 years. 75% experienced pruritus, of this group, 1 in 3 presented severe pruritus. Hyperphosphatemia and the use of antihistamines were associated with a higher prevalence of severe pruritus (RP 1.71, 95% CI 1.09-267 and RP 2.39, 95% CI 1.51-3.75, respectively). The positive serology for Hepatitis C Virus was described as a protective factor for presenting severe pruritus (RP 0.55, 95% CI 0.33-0.89). In conclusion, severe uremic pruritus is a frequent problem in patients with chronic terminal kidney disease who have hyperphosphatemia and treatment with antihistamines independently of the time they have been on hemodialysis.
本研究的目的是分析接受血液透析的终末期慢性肾病患者瘙痒严重程度的相关因素。所采用的方法基于对国家肾脏健康中心接受血液透析患者的横断面研究。严重瘙痒定义为视觉模拟量表评分大于或等于7分，并通过计算患病率比来评估与可能的风险因素的关联强度。关于结果，纳入了264例患者，59.9%为男性，血液透析平均时间为10.26±7.14年。75%的患者经历过瘙痒，其中三分之一出现严重瘙痒。高磷血症和使用抗组胺药与严重瘙痒的较高患病率相关（患病率比分别为1.71，95%可信区间为1.09 - 2.67和2.39，95%可信区间为1.51 - 3.75）。丙型肝炎病毒血清学阳性被描述为出现严重瘙痒的保护因素（患病率比0.55，95%可信区间为0.33 - 0.89）。总之，严重尿毒症瘙痒是终末期慢性肾病患者中常见的问题，这些患者存在高磷血症且接受抗组胺药治疗，与血液透析时间无关。
