The relationship between uremic pruritus and quality of life in haemodialysis patients and non-dialysis patients with stage 3-5 chronic kidney disease

. Chronic kidney disease (CKD) is a clinical condition characterized by the inability of the kidney to fully perform functions such as fluid electrolyte balance, endocrine and metabolic functions due to its inability to perform its current functions. Renal replacement therapies (RRT) are required when CKD progresses to end-stage renal disease (ESRD). Hemodialysis (HD) is the most commonly used RRT. Uremic pruritus (UP) is a very common symptom in patients with hemodialysis and chronic kidney disease (CKD) and affects the quality of life. The treatment of UP, whose etiology is not fully elucidated, is controversial and difficult. In this study, we aimed to evaluate the presence, frequency, etiology, and relationship between body region and quality of life of itching in HD patients and non-dialysis stage 3-5 CKD patients. Demographic and laboratory parameters were recorded from patient files and hospital automation system. The presence and degree of itching, body region and quality of life of the patients were evaluated. A total of 169 patients were included in our study. 55.0% of the patients participating in the study were male and 45.0% were female. The average age of the patients was 55.2 ± 16.7 years. The most common cause of ESRD was diabetes mellitus (DM) (26.0%). The second most common cause was hypertension (HT) (18.9%). Itching was present in 52.1% of the patients and the total 5-D itching score was 10.6 ± 4.0. In 21.9% of the patients with itching, the severity of itching was mild. A significant portion of the patients reported that their itching course did not change within days (63.9%). The most common body areas with itching were the back and feet/toes (37.9%, 32.5%, respectively). In the itching group, hemoglobin, serum ferritin, total cholesterol and LDL cholesterol values were statistically significantly lower and creatinine value was higher. There was no significant difference in PTH value. Patients with itching, compared to those without itching, in all WHOQoL-BREF contents; They had statistically significantly worse performance in general health status, physical health status, psychological status, social relations status and environmental status. Between the total score of the 5-D itch scale and the Hgb level; While there was a low negative correlation in the entire patient group, there was no correlation in the non-dialysis CKD group and HD group. 5-D itch scale total score and all WHOQoL-BREF contents; A low level negative correlation was observed in general health status, physical health status, psychological status, social relations status and environmental status. There was a statistically significant correlation between the total score of the 5-D itch scale and female gender and erythropoiesis-stimulating agent (ESA) use (independent of ESA type). UP is one of the parameters that affects the quality of life in HD patients and non-dialysis CKD patients. Lesions that occur as a result of scratching can become chronic and reduce the dermatological and general quality of life of patients. In particular, affecting sleep quality is an important indicator of mortality. Contradictory results between studies on factors related to itching indicate the need for new studies on this subject with long follow-up periods, multicenters, and large patient participation. A multidisciplinary treatment approach for the correct interpretation of itching is of great importance in reducing the mortality and morbidity of patients.