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接受透析的终末期肾病患儿的瘙痒特征:一项横断面研究

Pruritus Features in Children with End-Stage Renal Disease Underwent Dialysis: A Cross-Sectional Study.

作者信息

Mehrkash Mehryar, Golestaneh Seyed-Javad, Madihi Yahya, Paknazar Fatemeh, Hadian Mahdi, Akbari Mojtaba, Abtahi-Naeini Bahareh

机构信息

Imam Hossein Children's Hospital and Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.

School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Int J Pediatr. 2021 Jul 28;2021:9970321. doi: 10.1155/2021/9970321. eCollection 2021.

Abstract

OBJECTIVE

Evaluation of the pruritus features in children with end-stage renal disease (ESRD) who underwent dialysis at an academic tertiary pediatric dialysis center.

METHODS

This cross-sectional study was conducted at an academic tertiary pediatric dialysis center, Isfahan, Iran. The reviewed medical records of the children included their characteristics, dialysis properties, and laboratory parameters. The 4-item itch questionnaire was utilized to assess distribution, severity, frequency, and associated sleeping disorders.

RESULTS

Thirty ESRD patients with pruritus, including 23 males (76.7%) with a mean age of 11.7 ± 3.64 years, were recruited. The most common cause of CKD was nephronophthisis (23.3%). The median total score of pruritus was 5 (range: 3-15). The distribution score of pruritus was directly correlated with the age (Spearman's rho = 0.42, = 0.02) and serum level of parathyroid hormone (PTH) (Spearman's rho = 0.42, = 0.04). In the reduced multiple logistic regression model, the increasing level of serum calcium was associated with increased odds of having total pruritus score ≥ 5 (OR (odds ratio): 4.5; 95% CI 1.12 to 18.05). In addition, an increase in age for one year was found to be associated with 50% higher odds of having total pruritus score ≥ 5 (OR: 1.5; 95% CI 1.03 to 2.18).

CONCLUSION

Increased level of serum Ca and higher age were associated with increased odds of having more severe pruritus score in children.

摘要

目的

评估在一家学术性三级儿科透析中心接受透析的终末期肾病(ESRD)患儿的瘙痒特征。

方法

这项横断面研究在伊朗伊斯法罕的一家学术性三级儿科透析中心进行。回顾患儿的病历,包括其特征、透析特性和实验室参数。采用4项瘙痒问卷评估瘙痒的分布、严重程度、频率及相关睡眠障碍。

结果

招募了30例有瘙痒症状的ESRD患者,其中23例男性(76.7%),平均年龄为11.7±3.64岁。慢性肾脏病最常见的病因是肾单位肾痨(23.3%)。瘙痒的总评分中位数为5分(范围:3 - 15分)。瘙痒的分布评分与年龄(Spearman秩相关系数=0.42,P = 0.02)和甲状旁腺激素(PTH)血清水平(Spearman秩相关系数=0.42,P = 0.04)直接相关。在简化的多因素逻辑回归模型中,血清钙水平升高与瘙痒总评分≥5分的几率增加相关(比值比(OR):4.5;95%置信区间1.12至18.05)。此外,发现年龄每增加一岁,瘙痒总评分≥5分的几率高50%(OR:1.5;95%置信区间1.03至2.18)。

结论

血清钙水平升高和年龄较大与儿童瘙痒评分更严重的几率增加相关。

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本文引用的文献

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Metabolomic analysis of uremic pruritus in patients on hemodialysis.尿毒症瘙痒患者血液透析的代谢组学分析。
PLoS One. 2021 Feb 12;16(2):e0246765. doi: 10.1371/journal.pone.0246765. eCollection 2021.
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Strategies for Optimizing Growth in Children With Chronic Kidney Disease.优化慢性肾病患儿生长发育的策略
Front Pediatr. 2020 Jul 30;8:399. doi: 10.3389/fped.2020.00399. eCollection 2020.
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Disturbed skin barrier in children with chronic kidney disease.慢性肾脏病患儿的皮肤屏障功能紊乱。
Pediatr Nephrol. 2015 Feb;30(2):333-8. doi: 10.1007/s00467-014-2932-2. Epub 2014 Aug 17.

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