JLE

Néphrologie & Thérapeutique

MENU

Pruritus associated with chronic kidney disease in hemodialysis patients: a survey in French nephrologists Volume 19, issue 6, October 2023

Figures


  • Figure 1

  • Figure 2
Authors
1 AURA Paris Plaisance, service de dialyse et aphérèse thérapeutique, 185A, rue Raymond Losserand, 75014 Paris, France
2 Hôpital de Boulogne-sur-Mer, service de néphrologie et médecine, Boulogne-sur-Mer, France
3 Hôpital privé Claude Galien, Ramsay Santé, service de néphrologie et dialyse, Quincy-sous-Sénart, France
4 Collège de médecine des Hôpitaux de Paris, Paris, France
5 Maison du rein-Aurad-Aquitaine, Gradignan, France
6 Normandie Université, Unicaen, CHU de Caen Normandie, service de néphrologie, Caen, France
7 Normandie Université, Unicaen, UFR de médecine, Caen, France
8 ANTICIPE U1086 Inserm-UCN, Centre François Baclesse, Caen, France
9 Université de Brest, LIEN, Brest, France
10 CHU Brest, service de dermatologie, Brest, France
Correspondance : M. Touzot
mtouzot@gmail.com

Background

Chronic kidney disease-associated pruritus (CKD-aP) is common in hemodialysis patients and severely impairs their quality of life, but the practices of nephrologists remain poorly known.

Methods

The objective of this on-line survey was to describe the management of CKD-aP in French nephrologists affiliated with the French-speaking Society of Nephrology, Dialysis and Transplantation (SFNDT) and involved in hemodialysis.

Results

In total, 122 questionnaires were completed and 100 were usable. Nephrologists reported they personally managed a median of 52 patients; they estimated that the CKD-aP prevalence in their hemodialysis patients was a median of 10% (IQR, 6.3-17.2); 6% of nephrologists reported not following any patient with CKD-aP. In case of CKD-aP, the first-intention intervention was the evaluation of phosphocalcic metabolism (53.5%) and verification of dialysis adequacy (52%). For moderate-to-severe CKD-aP, the first-line prescription was topical therapy (71.3%), antihistamine (23.2%) and membrane change (15.9%). Patients were referred to a dermatologist mainly in case of treatment failure (86.9%) or scratching lesions (40.4%). Available treatments were considered ineffective for 50.5% of nephrologists, partially effective for 45.5% and effective for only 4%.

Conclusion

These results show that according to the opinion of nephrologists, the pruritus prevalence is low in dialysis patients. This is inconsistent with studies based on systematic patient interviews, thus suggesting that pruritus is a symptom overlooked by nephrologists. In the context of the arrival of a new drug for pruritus, patients should be more questioned about this symptom in order to propose this treatment.