Wang Teng, Goh Jing Xin, Seth Shrey, Do Linda Le, Tesfaye Wubshet, Sud Kamal, Van Connie, Small Fatima, Tarafdar Surjit, Castelino Ronald L
Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
School of Pharmacy, The University of Queensland, Brisbane, Australia.
J Nephrol. 2025 Mar;38(2):371-391. doi: 10.1007/s40620-025-02221-9. Epub 2025 Feb 25.
Chronic kidney disease-associated pruritus (CKD-aP) is a debilitating symptom that can significantly impact patients' daily activities and quality of life. This systematic review aimed to assimilate the latest evidence on the relationship between CKD-associated pruritis and patient-centred outcomes.
A comprehensive search was conducted to identify relevant studies in PubMed, Medline and Embase via OVID, CINAHL, and Web of Science from 2000 to June 2024. Quality appraisal and subsequent data extraction were performed using the Joanna Briggs Institute (JBI) tools and a modified extraction form derived from JBI.
The review included 29 studies with a total of 147,174 CKD patients, including those on haemodialysis (HD) and peritoneal dialysis (PD). The most frequently reported patient-centred outcomes included quality of life (n = 21), sleep quality (n = 17), anxiety/depression (n = 11) and mortality (n = 7). There was a paucity of data on patients in the pre-dialysis stages, those undergoing PD, and following a conservative (non-dialytic) pathway. The impact of CKD-associated pruritus on outcomes was contingent on the severity of CKD-associated pruritus. There was an association between increased medication usage, decreased compliance with HD treatments and higher rates of hospitalisation in patients experiencing severe pruritus.
Our review underscores the pernicious impact of CKD-associated pruritus on patient outcomes and emphasises the importance of effective management to improve patient-centred outcomes. Additional investigations are warranted among patients undergoing PD, those in pre-dialysis stages, and on conservative (non-dialytic) pathways, to achieve a more comprehensive understanding of the impact of CKD-associated pruritus in these patient groups.
慢性肾脏病相关瘙痒（CKD-aP）是一种使人衰弱的症状，会显著影响患者的日常活动和生活质量。本系统评价旨在汇总有关CKD相关性瘙痒与以患者为中心的结局之间关系的最新证据。
通过OVID在PubMed、Medline和Embase、CINAHL以及Web of Science中进行全面检索，以识别2000年至2024年6月的相关研究。使用乔安娜·布里格斯研究所（JBI）工具和源自JBI的改良提取表进行质量评估和后续数据提取。
该评价纳入了29项研究，共147174例CKD患者，包括接受血液透析（HD）和腹膜透析（PD）的患者。最常报告的以患者为中心的结局包括生活质量（n = 21）、睡眠质量（n = 17）、焦虑/抑郁（n = 11）和死亡率（n = 7）。关于透析前阶段患者、接受PD治疗的患者以及采用保守（非透析）治疗路径患者的数据较少。CKD相关性瘙痒对结局的影响取决于CKD相关性瘙痒的严重程度。在经历严重瘙痒的患者中，药物使用增加、HD治疗依从性降低和住院率较高之间存在关联。
我们的评价强调了CKD相关性瘙痒对患者结局的有害影响，并强调了有效管理以改善以患者为中心的结局的重要性。有必要对接受PD治疗患者、透析前阶段患者以及采用保守（非透析）治疗路径的患者进行进一步调查，以更全面地了解CKD相关性瘙痒对这些患者群体的影响。
