Pruritus, Related Factors and Pruritus Management in End Stage Renal Disease Patients: Nurse’s Roles

Authors

  • Kingkamon Phetsri Instructor, The School of Nursing, Walailak University
  • Kantaporn Yodchai Assistance Professor, Faculty of Nursing, Prince of Songkla University

Keywords:

Pruritus, Nurse’s roles, Pruritus management, End stage renal disease

Abstract

          This article aimed to review the current evidence on pruritus, related factors and management of pruritus in end stage renal disease (ESRD) patients. Pruritus is a common symptom in ESRD patients. Various factors related to pruritus in ESRD patients including immune-mediated, xerosis, increased histamine levels, opioid imbalance, hyperparathyroidism, peripheral neuropathy, and dialysis vintage. Pruritus affects the body, mind and quality of life of ESRD patients. Thus, nurses have vital roles in pruritus management to assist ESRD patients by focusing on non-pharmacological and prescribed pharmacological management in order to improve pruritus, physical comfort, quality of sleep and quality of life.

References

Alahi, M., Amin, M., Ali, M., Kafiluddin, M., & Ahmad, Q. (2013). Neuropathy in Chronic Renal Failure. Bangladesh Journal of Neuroscience, 28(2), 116-127. doi:10.3329/bjn.v28i2.17183

Aramwit, P., & Supasyndh, O. (2015). Uremic Pruritus; Its Prevalence, Pathophysiology and Management. Retrieved from: https://www.intechopen.com/books/updates-in-hemodialysis/uremic-pruritus-its-prevalence-pathophysiology-and-Management.

BC Renal Agency. (2017). Management of pruritus in patients with chronic kidney disease. Retrieved from http://www.bcrenalagency.ca/resourcegallery/Documents/Management%20of%20Pruritus%20in%20Patients%20with%20Chronic%20Kidney%20Disease.pdf.

Combs, S. A., Teixeira, J. P., & Germain, M. J. (2015). Pruritus in Kidney Disease. Seminars in nephrology, 35(4), 383–391. doi:10.1016/j.semnephrol.2015.06.009

Eusebio-Alpapara, K. M. V., Castillo, R. L., & Dofitas, B. L. (2020). Gabapentin for uremic pruritus: a systematic review of randomized controlled trials. International Journal of Dermatology, 59(4), 412-422. doi:10.1111/ijd.14708

Feily, A., Dormanesh, B., Ghorbani, A. R., Moosavi, Z., Kouchak, M., Cheraghian, B., . . . Ranjbari, N. (2012). Efficacy of topical cromolyn sodium 4% on pruritus in uremic nephrogenic patients: a randomized double-blind study in 60 patients. International Journal of Clinical Pharmacology and Therapeutics, 50(7), 510-513. doi:10.5414/cp201629

Jaiswal, D., Uzans, D., Hayden, J., Kiberd, B. A., & Tennankore, K. K. (2016). Targeting the Opioid Pathway for Uremic Pruritus: A Systematic Review and Meta-analysis. Canadian Journal of Kidney Health and Disease. 3, 1-9. doi:10.1177/2054358116675345

Lavery, M. J., Kinney, M. O., Mochizuki, H., Craig, J., & Yosipovitch, G. (2016). Pruritus: an overview. What drives people to scratch an itch. Ulster Medical Journal, 85(3), 164-173.

Li, J., Guo, Q., Lin, J., Yi, C., Yang, X., & Yu, X. (2015). Prevalence and Associated Factors of Uraemic Pruritus in Continuous Ambulatory Peritoneal Dialysis Patients. Internal Medicine Journal, 54(22), 2827-2833. doi:10.2169/internalmedicine.54.4516

Min, J.-W., Kim, S.-H., Kim, Y. O., Jin, D. C., Song, H. C., Choi, E. J., . . . Kim, Y. K. (2016). Comparison of uremic pruritus between patients undergoing hemodialysis and peritoneal dialysis. Kidney research and clinical practice, 35(2), 107-113. doi:10.1016/j.krcp.2016.02.002

Nowak, D., & Yeung, J. (2017). Diagnosis and treatment of pruritus. Canadian Family Physician, 63(12), 918-924.

Ozen, N., Cinar, F. I., Askin, D., & Mut, D. (2018). Uremic pruritus and associated factors in hemodialysis patients: A multi-center study. Kidney research and clinical practice, 37(2), 138-147. doi:10.23876/j.krcp.2018.37.2.138

Pakfetrat, M., Basiri, F., Malekmakan, L., & Roozbeh, J. (2014). Effects of turmeric on uremic pruritus in end stage renal disease patients: a double-blind randomized clinical trial. Journal of Nephrology, 27(2), 203-207. doi:10.1007/s40620-014-0039-2

Phan, N. Q., Blome, C., Fritz, F., Gerss, J., Reich, A., Ebata, T., . . . Ständer, S. (2012). Assessment of pruritus intensity: prospective study on validity and reliability of the visual analogue scale, numerical rating scale and verbal rating scale in 471 patients with chronic pruritus. Acta Derm Venereol, 92(5), 502-507. doi:10.2340/00015555-1246

Razeghi, E., Eskandari, D., Ganji, M. R., Meysamie, A. P., Togha, M., & Khashayar, P. (2009). Gabapentin and uremic pruritus in hemodialysis patients. Renal Failure, 31(2), 85-90. doi:10.1080/08860220802595476

Rehman, I. U., & Khan, T. M. (2017). Validity and reliability of the Urdu version of the 5D itching scale to assess pruritus among patients with chronic kidney disease in Pakistan. BMC nephrology, 18(1), 302. doi:10.1186/s12882-017-0717-0

Rehman, I. U., & Khan, T. (2020). Effect of chronic kidney diseases-associated pruritus on patients’ sleep quality, well-being and its management. Progress In Microbes & Molecular Biology, 3(1), 1-6. doi:10.36877/pmmb.a0000067

Satti, M. Z., Arshad, D., Javed, H., Shahroz, A., Tahir, Z., Ahmed, M. M. H., & Kareem, A. (2019). Uremic Pruritus: Prevalence and Impact on Quality of Life and Depressive Symptoms in Hemodialysis Patients. Cureus, 11(7), 1-10. doi:10.7759/cureus.5178

Sherjeena, P. B., Binitha, M. P., Rajan, U., Sreelatha, M., Sarita, S., Nirmal, C., & Deepthi, N. S. (2017). A controlled trial of narrowband ultraviolet B phototherapy for the treatment of uremic pruritus. Indian journal of dermatology, venereology and leprology, 83(2), 247–249. doi: 10.4103/0378-6323.198464

Shirazian, S., Aina, O., Park, Y., Chowdhury, N., Leger, K., Hou, L., . . . Mathur, V. S. (2017). Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges. International journal of nephrology and renovascular disease, 10, 11-26. doi:10.2147/IJNRD.S108045

Song, J., Xian, D., Yang, L., Xiong, X., Lai, R., & Zhong, J. (2018). Pruritus: Progress toward Pathogenesis and Treatment. BioMed Research International, 2018(17), 1-7. 9625936. doi:10.1155/2018/9625936

Swarna, S. S., Aziz, K., Zubair, T., Qadir, N., & Khan, M. (2019). Pruritus Associated With Chronic Kidney Disease: A Comprehensive Literature Review. Cureus, 11(7), e5256. doi:10.7759/cureus.5256

Tajbakhsh, R., Joshaghani, H., Bayzayi, F., Haddad, M., & Qorbani, M. (2013). Association between pruritus and serum concentrations of parathormone, calcium and phosphorus in hemodialysis patients. Saudi Journal of Kidney Diseases and Transplantation, 24(4), 702-706. doi:10.4103/1319-2442.113858

Tarikci, N., Kocatürk, E., Güngör, Ş., Oğuz Topal, I., Ülkümen Can, P., & Singer, R. (2015). Pruritus in Systemic Diseases: A Review of Etiological Factors and New Treatment Modalities. The Scientific World Journal, 2015, 1-8. 803752. doi:10.1155/2015/803752

Verduzco, H. A., & Shirazian, S. (2020). CKD-Associated Pruritus: New Insights Into Diagnosis, Pathogenesis, and Management. Kidney International Reports. doi:https://doi.org/10.1016/j.ekir.2020.04.027

Wu, H. Y., Peng, Y. S., Chen, H. Y., Tsai, W. C., Yang, J. Y., Hsu, S. P., . . . Chiu, H. C. (2016). A Comparison of Uremic Pruritus in Patients Receiving Peritoneal Dialysis and Hemodialysis. Medicine (Baltimore), 95(9), e2935. doi:10.1097/md.000000000000 2935

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Published

2020-10-24

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Academic Article