Krajewski Piotr K, Olczyk Piotr, Krajewska Magdalena, Krajewski Wojciech, Szepietowski Jacek C
Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland.
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
Front Med (Lausanne). 2021 Jan 20;7:615334. doi: 10.3389/fmed.2020.615334. eCollection 2020.
Chronic itch is the most common symptom in dermatology. End-stage renal disease-associated chronic itch (ESRDCI) is a common burden affecting up to 35% of patients treated with hemodialysis. Kidney transplant (KTx) is believed to be the best renal replacement therapy leading to the elimination of ESRDCI. The study was undertaken to characterize and assess the prevalence of itch among patients after renal transplantation. Between October 2019 and January 2020, we analyzed the data of 197 patients comprising 121 males (61.4%) and 76 females (38.6%) and aged 54.5 ± 13.6 years. The data collection was performed with a specially designed questionnaire. Level of itch after renal transplantation was assessed with the use of a Numeral Rating Scale, a Visual Rating Scale, and 4-Item Itch Questionnaire. Moreover, the previous 3 days of itching were evaluated. The patients suffered from chronic renal disease for 20.2 ± 12.3 years, with a mean time of pre-transplant dialysis of 2.6 ± 2.4 years and a mean time after the KTx of 8.0 ± 6.5 years. The itch was present in 38.6% of the patients during the hemodialysis, and in 73.7% of cases, the itch ceased completely after the successful transplantation. Moreover, only 2.63% of the cases had no improvement. Nevertheless, the itch was reported in 42 (21.3%) renal transplant recipients (RTR), and in 22 (52.4%) cases, the itch appeared after transplantation. The majority of patients suffering from itch were women (54.8%). Itch in the last 3 days was reported in 21 patients. The itch's severity was assessed with a numerical rating scale (NRS), with the worst severity measured at 6 ± 2.2 points indicating moderate itch. In most cases (57.1%), itch affected multiple body areas. Extremities (50%) and the back (50%) were among the most frequently affected areas. The sensation had a mostly short duration and was most frequently reported in the evening. Only eight patients suffered for the whole day. Hot water was the most frequently reported (16.7%) alleviating factor, whilst sweat was responsible for itch aggravation in 35.9% of cases. Our analysis on representative patients' population indicates that itch after KTx is an important problem. Moreover, it is worth noting that more than half of the RTR did not suffer from itch during dialysis.
慢性瘙痒是皮肤科最常见的症状。终末期肾病相关的慢性瘙痒（ESRDCI）是一个常见负担，影响高达35%接受血液透析治疗的患者。肾移植（KTx）被认为是导致ESRDCI消除的最佳肾脏替代疗法。本研究旨在描述和评估肾移植术后患者瘙痒的患病率。在2019年10月至2020年1月期间，我们分析了197例患者的数据，其中包括121名男性（61.4%）和76名女性（38.6%），年龄为54.5±13.6岁。数据收集使用专门设计的问卷进行。肾移植术后的瘙痒程度使用数字评分量表、视觉评分量表和4项瘙痒问卷进行评估。此外，还对前3天的瘙痒情况进行了评估。患者患有慢性肾病20.2±12.3年，移植前透析平均时间为2.6±2.4年，肾移植术后平均时间为8.0±6.5年。在血液透析期间，38.6%的患者存在瘙痒，在73.7%的病例中，成功移植后瘙痒完全消失。此外，只有2.63%的病例没有改善。然而，42例（21.3%）肾移植受者（RTR）报告有瘙痒，其中22例（52.4%）的瘙痒在移植后出现。大多数瘙痒患者为女性（54.8%）。21例患者报告了过去3天的瘙痒情况。使用数字评分量表（NRS）评估瘙痒的严重程度，最严重程度为6±2.2分，表明为中度瘙痒。在大多数情况下（57.1%），瘙痒影响多个身体部位。四肢（50%）和背部（50%）是最常受影响的部位。这种感觉大多持续时间较短，最常在晚上报告。只有8名患者瘙痒持续一整天。热水是最常被报告的（16.7%）缓解因素，而汗液在35.9%的病例中会加重瘙痒。我们对具有代表性的患者群体的分析表明，肾移植术后瘙痒是一个重要问题。此外，值得注意的是，超过一半的RTR在透析期间没有瘙痒。
