Uremic Pruritus in the Maintenance of Hemodialysis Patients

血液透析病患尿毒性搔癢症之臨床研究

邱文淵(Wen-Yuan Chiu) ； 張浤榮(Horng-Rong Chang) ； 林文鶯(Enny Halim) ； 連榮達(Jong-Da Lian)

《Acta Nephrologica》 17卷2期 (2003/05) Pp. 63-68

摘要

Pruritus is a common symptom among patients on hemodialysis (HD). We studied 68 HD patients to assess the role of iron status, anemia, inflammation, serum beta2-micro globulin (β2M) levels and other common serum and dialysis parameters particularly in uremic pruritis. The intensity of pruritus was quantified into three groups: mild, moderate, and severe. Fifty-six percent of the patients had pruritus, with mild pruritus in 17% (n=12), moderate pruritus in 20% (n=14) and severe pruritus in 17% (n=12). The patients with pruritus had higher serum C-reactive protein (CRP) levels than patients without pruritus (1.34±2.10 vs 0.17±0.34, p=0.002). In addition, the serum CRP levels demonstrated an upward trend in patients with more severe intensity of pruritus (p＜0.05). The parameters related to anemia, platelet count, serum iPTH levels, EPO dosage and iron status did not differ between patients with or without pruritus, and neither did age, sex, presence or absence of diabetes mellitus (DM), HD duration, time on HD treatment, serum β2M levels, KT/V or nPCR. The serum calcium levels were higher in patients with pruritus than in those without pruritus (9.73±9.68 vs 9.42±9.55, p=0.046). Although the serum calcium levels also showed an upward trend in patients with more severe pruritus, it was not statistically significant (p=0.143). In summary, our findings suggest inflammation and serum calcium may play a role in the pathogenesis of uremic pruritus.

關鍵字

尿毒性搔癢症 ； 血液透析 ； C-反應蛋白 ； 血清鈣

並列摘要

Pruritus is a common symptom among patients on hemodialysis (HD). We studied 68 HD patients to assess the role of iron status, anemia, inflammation, serum beta2-micro globulin (β2M) levels and other common serum and dialysis parameters particularly in uremic pruritis. The intensity of pruritus was quantified into three groups: mild, moderate, and severe. Fifty-six percent of the patients had pruritus, with mild pruritus in 17% (n=12), moderate pruritus in 20% (n=14) and severe pruritus in 17% (n=12). The patients with pruritus had higher serum C-reactive protein (CRP) levels than patients without pruritus (1.34±2.10 vs 0.17±0.34, p=0.002). In addition, the serum CRP levels demonstrated an upward trend in patients with more severe intensity of pruritus (p＜0.05). The parameters related to anemia, platelet count, serum iPTH levels, EPO dosage and iron status did not differ between patients with or without pruritus, and neither did age, sex, presence or absence of diabetes mellitus (DM), HD duration, time on HD treatment, serum β2M levels, KT/V or nPCR. The serum calcium levels were higher in patients with pruritus than in those without pruritus (9.73±9.68 vs 9.42±9.55, p=0.046). Although the serum calcium levels also showed an upward trend in patients with more severe pruritus, it was not statistically significant (p=0.143). In summary, our findings suggest inflammation and serum calcium may play a role in the pathogenesis of uremic pruritus.

並列關鍵字

uremic pruritus ； hemodialysis ； C-reactive protein ； calcium