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Background: To observe the treatment effects of different dialysis modalities on pruritus in elderly uremic patients.
Methods: After screening, 67 elderly dialysis patients were selected, including 25 hemodialysis (HD) patients, 20 HD combined with hemodiafiltration (HD + HDF) patients, and 22 peritoneal dialysis (PD) patients. The β2-microglobulin...
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... the initial dialysis, the b2-MG and iPTH levels of the three groups were all not significantly different (all p > 0.05). When compared with the levels before the initial dialysis, the b2-MG level in the HD group changed from 16. 25 weeks, the b2-MG and iPTH levels in the HDF and PD groups were both significantly lower than that in the HD group (both p < 0.05; Tables 3 and 4). ...
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Background: There are few reports on the role of perito-neal dialysis in critically ill patients requiring continuous renal replacement therapies. ♦ Methods: Patients with acute kidney injury and multi-organ involvement were randomly allotted to continuous venovenous hemodiafiltration(CVVHDF, group A) or to continuous peritoneal dialysis (CPD, grou...
Citations
... Although uremic pruritus is an irritating symptom for patients with kidney failure, studies on its general definition and its effect on patients are limited (9,14,15). When these studies in the literature are evaluated, it is seen that uremic pruritus is often evaluated using one-dimensional scales, visual/ numerical scales or questionnaire questions compiled by researchers from the literature. ...
... (min=0, max=10) (24). In the study comparing three different dialysis methods, it was found that the itching rate seen in HD patients was 24%, while it was found that the itching rate in HD patients increased in the following sessions (15). When these rates were evaluated, it was determined that an irritating symptom such as itching was experienced intensely both in duration and in degree. ...
Introduction: Although uremic pruritus is not a life-threatening problem itself, it affects the quality of life and daily life activities of the patients and negatively changes the patient's adaption to the disease. Methods: This descriptive and analytical study was conducted with 219 patients who underwent hemodialysis in State Hospital, University Hospital hemodialysis units and a private dialysis center and met the study criteria. Research data were collected using the Introductory Information Form, 5-D Pruritus Scale and Pittsburg Sleep Quality Index. In the analysis of the data, t test, One - Way ANOVA test, Mann-Whitney U test, Kruskal-Wallis T test, Perason correlation analysis and Dunnet T3 Post Hoc test were used. Results: In the study, the 5-D Pruritus Scale mean score of the patients was 12.70±3.35 points, and the Pittsburg Sleep Quality Index score was 12.82±2.42. A positive, moderately significant (r=.509, p
... Globally the high-flux haemodialysis is the most commonly used blood purification method. But in developing countries such as Pakistan, low-flux dialysis is the main method of extracorporeal blood purification therapy due to insufficient funds to purchase high flux dialyzers [106] . Haemodialysis machines are also limited in Pakistan as in 2004 there were 140 dialysis centers although in 2009 these machines increased to 175 [107] , alarmingly out of the available dialysis centers in Pakistan, 10-15% are non-functional and the patients have limited access to treatment [107] . ...
Almost 50–90% of chronic kidney disease patients undergoing haemodialysis have been reported to have Chronic kidney disease-associated pruritus (CKD-aP). The intensity of CKD-aP may vary from a mild itch to an unbearable pruritic sensation which interferes with the patient’s quality of life. CKD-aP has become one of the upmost distressing cutaneous and most common symptom of chronic kidney disease which is often overlooked by nephrologists, primary care physicians, and other health-care professionals. Typically sleep disorders, mental and social well-being have been correlated with chronic kidney disease patients. With that this article presents vital comprehensive review which includes epidemiology of chronic kidney disease in Malaysia and Pakistan, CKD-associated pruritus and other dermatological disorders associated with chronic kidney diseases, pathophysiology of CKD-associated pruritus, clinical features of chronic kidney disease-associated pruritus, diagnosis of CKD-associated uremic pruritus, differential diagnosis of CKD-associated uremic pruritus, assessment and quantification of pruritus severity.
... However, this method is not very effective at removing the middle-molecule uremic toxins to provide relief from Uremic Pruritus. [26] Similarly, another study also supports the notion that the use of low-flux dialyzer is significantly associated with the aggravation of pruritus. [27] The high flux dialyzers efficiently remove averagesized molecules. ...
Chronic kidney disease (CKD)-associated pruritus is one of the most common symptoms found in patients who undergo dialysis for CKD, leading to a compromised quality of life. This study aimed to investigate the association between CKD-associated pruritus and the quality of life in patients undergoing hemodialysis in Pakistan.
A cross-sectional multicenter study was carried out from July 2016 to April 2017 in 2 tertiary care hospitals in Pakistan. Patients aged 18 years and above of both genders, undergoing hemodialysis, understood the Urdu language, and were willing to participate; were included.
Of 354 recruited patients with a response rate of 100%, majority (66.1%) of the patients were males. The median (intra-quartile range [IQR]) age of patients was 42.0 [34.0–50.0] years. The prevalence of pruritus was 74%. The median [IQR] score for pruritus was 10.0 (out of possible 25) [8.0–12.0]. Multivariate linear regression revealed a statistically significant association between CKD-associated pruritus with age of patients (β = 0.031; 95% confidence interval [CI] = 0.002–0.061; P = .038), duration of CKD (β = −0.013; 95% CI = −0.023 –−0.003; P = .014) and quality of life (β= −0.949; 95% CI = −1.450; −0.449). The median [IQR] score for health-related quality of life was 52.00 [43.00–58.00].
Prevalence of CKD-associated pruritus was reported to be 74% and it negatively affected the patient's quality of life. Patients with moderate to severe CKD-associated pruritus have poor quality of life. With an increase in intensity of pruritus, the QOL score decreased among the patients undergoing hemodialysis.
Background: Chronic kidney disease (CKD)-associated pruritus is a common complicationin patients with end-stage renal disease.
Objectives: To compare the capabilities of hemodialysis (HD) and hemodiafiltration(HDF) in clearing toxins and their effects on pruritus inuremic patients.
Patients and methods: The study included 40 adult subjects (18 years or older) who had maintenance dialysis for at least three months. Patients were divided into two groups: Group I: 20 patients underwent maintenance HDF (Intervention group), Group II: 20 patients underwent maintenance HD (Control group). Serum calcium levels, serum phosphorus levels, serum parathormone levels (PTH) and serum B2 microglobulin were assessed. The severity of pruritus measured by the visual analogue scale (VAS).
Results: The prevalence of Uremic Pruritus in our study was 52.5% in all studied patients.We found a statistically significant difference (p-value < 0.05) between studied groups as regard Uremic Pruritis.The prevalence of UP was higher in HD group (70 %) in compare with HDF group (35 %). We found a Statistically significant difference (p-value < 0.05) between HDF group & HD group regard B2 mico-globulin &PTH. Levels of PTH and B2 microglobulin were significantly higher in HD group(175.2 ± 36.1pg/ml and 11.3 ± 2.1μg/ml, respectively) as compared with HDF group (207.9 ± 36.4pg/ml and 14.1 ± 4.04μg/ml, respectively).
Conclusion: The prevalence and severity of Uremic Pruritus were significantlylower among HDF patients than HD patients. HDF can clear b2-MG and PTH and provide relief from pruritus efficiently more than HD.
