A Longitudinal Study of Uremic Pruritus in Hemodialysis Patients
A Longitudinal Study of Uremic Pruritus in Hemodialysis Patients
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DOI：
10.2215/cjn.00100110
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发表时间：
2010-08-01
影响因子：
9.8
通讯作者：
McGuire, Dawn
中科院分区：
文献类型：
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作者：
Mathur, Vandana S.;Lindberg, Jill;McGuire, Dawn
背景和目标：虽然尿毒症性瘙痒症（UP）是慢性肾脏疾病的一种非常普遍的并发症，但其特征仍不明确。目前还没有纵向研究的自然史，并没有健康相关的生活质量（HR-QOL）的文书已开发的UP。本研究的目的是描述自然史的UP，比较瘙痒强度的评级量表，并评估的实用性和有效性的HR-QOL仪器为UP.Design，设置，参与者，和测量：的强度，严重程度和影响的病理性瘙痒HR-QOL前瞻性评估103例慢性血液透析UP患者。结果措施，获得在预定的时间间隔超过3.5 months.Results：瘙痒每天或几乎每天报告的84%的患者，并已持续超过1年的59%。在83%的患者中，瘙痒累及双侧对称的大面积非皮区。三分之二的患者使用抗组胺药、类固醇和各种润肤剂等药物，但瘙痒症状没有得到满意的缓解。瘙痒强度、严重程度和HR-QOL指标在情绪、社会关系和睡眠等领域之间存在统计学显著相关性。在中度至重度UP患者中，瘙痒强度的20%或更大的变化与HR-QOL measurements.Conclusions显着降低相关：这是UP的第一次纵向研究描述了UP的主要特征及其对HR-QOL的影响。我们开发的评估工具易于使用，对UP强度的变化做出反应，并应有助于临床评估和研究，以满足患者的需求。Clin J Am Nephrol 5：1410-1419，2010. doi：10.2215/CJN.00100110
Background and objectives: Although uremic pruritus (UP) is a highly prevalent complication of chronic kidney disease, it remains poorly characterized. There have been no longitudinal studies of natural history, and no health-related quality of life (HR-QOL) instruments have been developed for UP. The objectives of this study were to describe the natural history of UP, to compare rating scales of itching intensity, and to assess usefulness and validity of HR-QOL instruments for UP.Design, setting, participants, & measurements: The intensity, severity, and effects of pathologic itching on HR-QOL were assessed prospectively in 103 patients with UP on chronic hemodialysis. Outcome measures were obtained at scheduled intervals over 3.5 months.Results: Itching daily or nearly daily was reported by 84% of patients and had been ongoing for >1 year in 59%. In 83%, pruritus involved large, nondermatomal areas with striking bilateral symmetry. Two thirds of the patients were using medications such as antihistamines, steroids, and various emollients without satisfactory relief of itching. Statistically significant associations were found among itching intensity, severity, and HR-QOL measures in domains such as mood, social relations, and sleep. Among patients with moderate-to-severe UP, changes in itching intensity of 20% or greater were associated with significant reductions in HR-QOL measures.Conclusions: This first longitudinal study of UP describes key features of UP and its effect on HR-QOL. The assessment instruments we have developed are easily used, are responsive to changes in UP intensity, and should facilitate clinical evaluation and research to meet the needs of afflicted patients. Clin J Am Nephrol 5: 1410-1419, 2010. doi: 10.2215/CJN.00100110