Uremic pruritus and long-term morbidities in the dialysis population

• Published in: PloS one 2020-10, Vol.15 (10), p.e0241088-e0241088
• Main Authors: Ting, Sze-Wen, Fan, Pei-Chun, Lin, Yu-Sheng, Lin, Ming-Shyan, Lee, Cheng-Chia, Kuo, George, Chang, Chih-Hsiang
• Format: Article
• Language: English
• Subjects: Aged; Antihistamines; Biology and Life Sciences; Cardiology; Catheters; Codes; Comorbidity; Congestive heart failure; Dialysis; Disease; Drug dosages; Female; Health insurance; Heart attacks; Heart diseases; Heart failure; Heart Failure - mortality; Hemodialysis; Hemodialysis patients; Histamine; Hospitalization; Hospitals; Humans; Infections; Infections - mortality; Itching; Male; Medical instruments; Medicine and Health Sciences; Middle Aged; Narcotics; Nephrology; Nosocomial infections; Parathyroidectomy; Parathyroidectomy - mortality; Pathogenesis; Patient outcomes; Patients; People and Places; Peritoneal dialysis; Peritoneum; Personal information; Physical sciences; Population; Prognosis; Pruritus; Pruritus - epidemiology; Quality of life; Renal Dialysis - adverse effects; Risk Factors; Social Sciences; Subgroups; Taiwan - epidemiology
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0241088

Uremic pruritus (UP) is a multifactorial problem that contributes to low quality of life in dialysis patients. The long-term influences of UP on dialysis patients are still poorly understood. This study aims to elucidate the contribution of UP to long-term outcomes. We used the Taiwan National Health Insurance Research Database to conduct this study. Patients on chronic dialysis were included and divided into UP and non-UP groups according to the long-term prescription of antihistamine in the absence of other indications. The outcomes include infection-related hospitalization, catheter-related infection, major adverse cardiac and cerebrovascular events (MACCE) and parathyroidectomy. After propensity score matching, 14,760 patients with UP and 29,520 patients without UP were eligible for analysis. After a mean follow-up of 5 years, we found that infection-related hospitalization, MACCE, catheter-related infection, heart failure and parathyroidectomy were all slightly higher in the UP than non-UP group (hazard ratio: 1.18 [1.16-1.21], 1.05 [1.01-1.09], 1.16 [1.12-1.21], 1.08 [1.01-1.16] and 1.10 [1.01-1.20], respectively). Subgroup analysis revealed that the increased risk of adverse events by UP was generally more apparent in younger patients and patients who underwent peritoneal dialysis. UP may be significantly associated with an increased risk of long-term morbidities.