Chronic Kidney Disease Associated Pruritus (CKD-aP) represents a localized or a generalized skin itch, which is a common symptom occurring in end-stage renal disease and dialysis. The prevalence of CKD-aP in adults on dialysis varies between countries ranging between 20-42%. Swiss data on CKD-aP are unfortunately largely lacking, as Switzerland is so far not part of large registries, such as DOPPS. The aging population, the increase in diabetes (69% by 2030), the increase in hypertension (60% by 2025) and poly-morbidity will probably lead to a rise in the number of patients on dialysis and subsequent CKD-aP. CKD-aP is associated with sleep disturbances, compromised quality of life, emotional distress, and increased risks of hospitalization and death. Its management lacks approaches that are supported by strong evidence because its pathogenesis remains poorly understood and may be related to an increase in uremic toxins, skin inflammation. In this context, sweat composition deserves more attention. Aim of the study The aim of the study is to determine the prevalence of CKD-aP in the population on dialysis, the association between CKD-aP and different electrolytes, and the potential role of the composition of sweat in CKD-aP. Results will be used for building a CKD-aP symptom management program to improve the quality of care of patients on dialysis and will be incorporated in the nursing continuing education program.
Study Type
OBSERVATIONAL
Enrollment
401
Identification of CKD-aP prevalence and severity among patients on dialysis.
University of Lausanne Hospitals
Lausanne, Canton of Vaud, Switzerland
Prevalence of CKD-aP
Evaluation of the presence of CKD-aP. This outcome prevalence will be reported in %.
Time frame: June 27, 2022- October 31, 2023
Severity of CKD-aP using the Visual Analog Scale
Severity of CKD-aP will be measured using the Visual Analog Scale (VAS) questionnaire. Participants will be asked to rate their maximum pruritus intensity during the last 24 hours. The VAS score ranges from 0 (not itchy) to 10 (extremely itchy); Severity will be classified into five categories: 1) 0 = no pruritus, 2) 0.1-2.9 points = mild pruritus, 3) 3.0-6.9 points = moderate pruritus, 4) 7.0-8.9 points = severe pruritus, and 5) 9.0-10.0 points = very severe pruritus. Higher scores indicate a worse outcome.
Time frame: June 27, 2022- October 31, 2023
Severity of CKD-aP using the Verbal Rating Scale
Severity of CKD-aP will also be measured using the Verbal Rating Scale (VRS) questionnaire. Participants will be asked to rate their maximum pruritus intensity during the last 24 hours. The VRS is a five-point scale and consists of a list of adjectives describing various levels of symptom intensity (0= no itch, 1= mild itch, 2= moderate itch, 3= severe itch and 4=very severe itch). Higher scores indicate a worse outcome.
Time frame: June 27, 2022- October 31, 2023
Sodium level (mmol/l) in sweat
Measurement of sodium (mmol/l) in a subgroup of patients with CKD-aP and their age-sex-matched controls on dialysis. 60 participants (30 cases and 30 controls)
Time frame: June 27, 2022- October 31, 2023
Chloride level (mmol/l) in sweat
Measurement of chloride (mmol/l) in a subgroup of patients with CKD-aP and their age-sex-matched controls on dialysis. 60 participants (30 cases and 30 controls)
Time frame: June 27, 2022- October 31, 2023
Potassium level (mmol/l) in sweat
Measurement of potassium (mmol/l) in a subgroup of patients with CKD-aP and their age-sex-matched controls on dialysis. 60 participants (30 cases and 30 controls)
Time frame: June 27, 2022- October 31, 2023
Calcium level (mg/l) in sweat
Measurement of calcium (mg/l) in a subgroup of patients with CKD-aP and their age-sex-matched controls on dialysis. 60 participants (30 cases and 30 controls)
Time frame: June 27, 2022- October 31, 2023
Phosphorus level (mg/ml) in sweat
Measurement of phosphorus (mg/ml) in a subgroup of patients with CKD-aP and their age-sex-matched controls on dialysis. 60 participants (30 cases and 30 controls)
Time frame: June 27, 2022- October 31, 2023
Urea level (mmol/l) in sweat
Measurement of urea (mmol/l) in a subgroup of patients with CKD-aP and their age-sex-matched controls on dialysis. 60 participants (30 cases and 30 controls)
Time frame: June 27, 2022- October 31, 2023
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