Lopes Marcelo Barreto, Karaboyas Angelo, Sukul Nidhi, Tsuruya Kazuhiko, Al Salmi Issa, Asgari Elham, Alyousef Anas, Schaufler Thilo, Walpen Sebastian, Menzaghi Frederique, Pisoni Ronald
Arbor Research Collaborative for Health, Ann Arbor, MI.
Department of Internal Medicine, Division of Nephrology, University of Michigan, Ann Arbor, MI.
Kidney Med. 2022 Apr 29;4(6):100476. doi: 10.1016/j.xkme.2022.100476. eCollection 2022 Jun.
RATIONALE & OBJECTIVE: Chronic kidney disease-associated pruritus has been linked with poorer mental and physical health-related quality of life (HR-QOL) in patients receiving hemodialysis. We used the Skindex-10 questionnaire and a single itch-related question to evaluate their prediction of HR-QOL.
Prospective, international cohort.
SETTING & PARTICIPANTS: We analyzed data from 4,940 patients receiving hemodialysis from 17 countries enrolled in phase 5 (2013) of the Dialysis Outcomes and Practice Patterns Study.
The responses to the 10 questions of Skindex-10 (0-6 scale) pertaining to itchiness in the past week were summed to create a summary score (range, 0-60). Concurrently, a single question from the Kidney Disease Quality of Life 36-item survey asked "during the past 4 weeks, to what extent were you bothered by itchy skin?" with 5 responses, ranging from "not at all" to "extremely" bothered.
Physical component summary (PCS) and mental component summary (MCS) scores of HR-QOL.
We used separate linear regression models to evaluate the predictive power, based on R values, for 3 models: 1 for each predictor and 1 with both predictors.
The correlation between the single itch-related question and the Skindex-10 score was 0.72. A 10-point higher Skindex-10 score was associated with a 1.2-point lower PCS score (95% CI, -1.4 to -0.9) and a 1.5-point lower MCS score (95% CI, -1.7 to -1.3) . The R value for PCS was 0.065 when the single question was used and only 0.033 when Skindex-10 was used as the predictor; the R value for MCS was 0.056 for the single question versus 0.052 for Skindex-10.
Measurement bias and translation issues in the questionnaires.
The single question about the extent to which the patients were bothered by itchy skin was highly correlated with the Skindex-10 score and at least as predictive of key HR-QOL measures. In daily clinical practice, using 1 simple question about the extent to which patients are bothered by itchy skin can be a feasible and efficient method for the routine assessment of pruritus.
慢性肾脏病相关瘙痒与接受血液透析患者较差的精神和身体健康相关生活质量（HR-QOL）相关。我们使用Skindex-10问卷和一个与瘙痒相关的单一问题来评估它们对HR-QOL的预测能力。
前瞻性国际队列研究。
我们分析了来自参与透析结果与实践模式研究第5阶段（2013年）的17个国家的4940例接受血液透析患者的数据。
将过去一周内对Skindex-10问卷中10个与瘙痒相关问题（0-6分制）的回答进行汇总，得出一个总分（范围为0-60）。同时，肾病生活质量36项调查问卷中的一个问题是“在过去4周内，您的皮肤瘙痒给您带来了多大困扰？”，有5个回答选项，从“完全没有”到“极其”困扰。
HR-QOL的身体成分总结（PCS）和精神成分总结（MCS）得分。
我们使用单独的线性回归模型，根据R值评估3个模型的预测能力：每个预测因素各一个模型，以及一个包含两个预测因素的模型。
与瘙痒相关的单一问题和Skindex-10得分之间的相关性为0.72。Skindex-10得分每高10分，PCS得分降低1.2分（95%CI，-1.4至-0.9），MCS得分降低1.5分（95%CI，-1.7至-1.3）。使用单一问题时，PCS的R值为0.065，使用Skindex-10作为预测因素时，R值仅为0.033；单一问题对MCS的R值为0.056，而Skindex-10为0.052。
问卷中的测量偏差和翻译问题。
关于患者皮肤瘙痒困扰程度的单一问题与Skindex-10得分高度相关，并且至少在预测关键HR-QOL指标方面具有同等效力。在日常临床实践中，使用一个关于患者皮肤瘙痒困扰程度的简单问题可能是一种可行且有效的瘙痒常规评估方法。
