학술논문

Novel approach to unpleasant symptom clusters surrounding pruritus in patients with chronic kidney disease and on dialysis therapy.
Document Type
article
Source
Current opinion in nephrology and hypertension. 31(1)
Subject
Humans
Pruritus
Syndrome
Renal Dialysis
Quality of Life
Renal Insufficiency
Chronic
Sleep Quality
Kidney Disease
Clinical Research
Behavioral and Social Science
7.3 Management and decision making
Management of diseases and conditions
7.1 Individual care needs
Generic health relevance
Renal and urogenital
Good Health and Well Being
chronic kidney disease
dialysis
pruritus
symptom cluster
unpleasant symptom
Clinical Sciences
Urology & Nephrology
Language
Abstract
Purpose of reviewChronic kidney disease-associated-pruritus (CKD-aP) is a common symptom in patients with end-stage kidney disease (ESKD) undergoing dialysis. CKD-aP typically occurs alongside other debilitating symptoms and may comprise so-called 'symptom clusters' which have synergistic effects that adversely impact patient health-related quality of life (HRQoL). Importantly, symptoms in a cluster may share a common biological mechanism. Here we review the clinical impact of CKD-aP and its association with other symptoms reported by dialysis patients. The clinical benefits of treating pruritus and its potential impact on other symptoms are also addressed.Recent findingsStudies have shown CKD-aP significantly impairs HRQoL in patients with ESKD undergoing dialysis and is associated with adverse clinical outcomes, including increased risk of infections, hospitalizations, and mortality. Despite these negative effects, CKD-aP remains underrecognized and undertreated in clinical practice. CKD-aP is frequently associated with other symptoms, including disturbed sleep/poor sleep quality, anxiety, depression, and pain. Clinical studies of antipruritic therapies show that reduction of itch intensity may also alleviate other associated symptoms, such as poor sleep quality.SummaryCKD-aP and its associated symptoms are inadequately managed in clinical practice. Greater understanding and awareness of CKD-aP and its surrounding symptom clusters in dialysis patients may improve their overall symptom management and HRQoL.