How do nephrologists in haemodialysis units consider the symptom of itch? Results of a survey in Germany

Despite advances in dialysis treatment of end-stage renal disease, pruritus remains a widespread and distressing concomitant of chronic renal failure. The prevalence of uraemic pruritus (UP) across countries ranges from 10 to 77%. Data from the DOPPS study showed that moderate to severe UP occurs in >40% of patients on haemodialysis. We aimed to provide data on how common and how serious a problem pruritus is as perceived by nephrologists in daily haemodialysis practice. Method. A national cross-sectional survey in 1420 nephrologists assessed information on the number of dialysed patients, gender distribution, perceived prevalence of UP, time-related aspects of UP, characteristics of UP and its association with dialysis and therapy of UP.Most respondents reported UP to be prevalent in 1-30% of their patients, and 30% reported an association between UP and dialysis. Seventy-five percent reported an undulating pattern. Nearly half the sample suggested a relationship between quality of dialysis and UP. No substantial differences in recognition and management of UP as a function of organizational affiliation were detected.The prevalence of UP may be underestimated by nephrologists. Large variation in the reported prevalence of UP and the undulating pattern of UP after dialysis may impede the recognition of UP.