Kim Dana, Pollock Carol
Department of Renal Medicine, Royal North Shore Hospital, Sydney, NSW, Australia.
Clin Kidney J. 2021 Oct 14;14(Suppl 3):i1-i7. doi: 10.1093/ckj/sfab142. eCollection 2021 Dec.
Chronic kidney disease-associated pruritus (CKD-aP) is a common, yet underrecognized condition in patients with CKD and end-stage kidney disease (ESKD). Real-world observational studies indicate that CKD-aP affects up to 80% of ESKD patients undergoing haemodialysis (HD), with ∼40% experiencing moderate to severe itch. CKD-aP can negatively impact patients' mental and physical health-related quality of life (HRQoL) and is also associated with sleep disturbance and depression. Several studies have found that CKD-aP is a predictor of adverse medical outcomes, including an increased risk of hospitalizations and mortality. In this article we review the literature relating to the epidemiology of CKD-aP to describe its prevalence across the treatment spectrum of CKD (non-dialysis, HD, peritoneal dialysis and transplant recipients) and to summarize potential risk factors associated with its development. We also review key data from studies that have evaluated the impact of CKD-aP on HRQoL and medical outcomes.
慢性肾脏病相关性瘙痒(CKD-aP)在慢性肾脏病(CKD)和终末期肾病(ESKD)患者中很常见,但却未得到充分认识。真实世界观察性研究表明,CKD-aP影响高达80%接受血液透析(HD)的ESKD患者,约40%经历中度至重度瘙痒。CKD-aP会对患者的心理健康和与身体健康相关的生活质量(HRQoL)产生负面影响,还与睡眠障碍和抑郁有关。多项研究发现,CKD-aP是不良医疗结局的预测指标,包括住院和死亡风险增加。在本文中,我们回顾了与CKD-aP流行病学相关的文献,以描述其在CKD治疗范围内(非透析、HD、腹膜透析和移植受者)的患病率,并总结与其发生相关的潜在风险因素。我们还回顾了评估CKD-aP对HRQoL和医疗结局影响的研究的关键数据。