Effects of chronic kidney disease-associated pruritus on quality of life in hemodialysis and non-dialysis patients: A cross-sectional study

Chronic kidney disease-associated pruritus (CKD-aP) is a common and distressing symptom, particularly in hemodialysis (HD) patients, significantly impacting their quality of life. This study aimed to investigate the effects of CKD-aP frequency and severity on quality of life in both HD and non-HD stage 3 - 5 CKD patients. This cross-sectional case-control study was conducted from January to May 2024. Pruritus was assessed using the 5-D itch scale, and quality of life was evaluated with the World Health Organization Quality of Life Scale-Short Form (WHOQoL-BREF) questionnaire. Correlations between pruritus severity and patient characteristics were analyzed. The study involved 169 patients, comprising 80 non-HD stage 3 - 5 CKD patients and 89 HD patients, with a mean age of 55.2 ± 16.7 years. Pruritus was significantly more prevalent in the HD group than in the non-HD group (61.8 vs. 41.3%, p = 0.008). HD patients had more pruritic body areas and higher 5-D itch scale scores (0 (0 - 8.5) vs. 0 (0 - 3.75), p = 0.002; 9.3 (8.0 - 14.8) vs. 8.0 (8.0 - 10.3), p = 0.003). In the HD group, pruritus was associated with lower quality of life in the psychological health, social relationships, and environment domains of the WHOQoL-BREF questionnaire (50.0 (35.4 - 58.3)% vs. 54.2 (42.7 - 66.7)%, p = 0.027; 50.0 (33.3 - 58.3)% vs. 50.0 (41.6 - 66.7)%, p = 0.046; 53.1 (40.6 - 65.5)% vs. 56.3 (50.0 - 68.8)%, p = 0.026, respectively). Pruritus also correlated with lower hemoglobin levels, higher serum creatinine levels, and poorer overall quality of life in both groups, with female sex and erythropoiesis-stimulating agent use as significant contributing factors. Pruritus significantly impairs the quality of life in HD patients.