| Objective:1.To investigate the prevalence rate and related clinical features of Uremic Pruritus(UP)in patients with Maintenance Hemodialysis(MHD)in the center;2.To Analyze the factors related to the occurrence of UP,and to explore the risk factors affecting the occurrence of UP,so as to provide certain theoretical basis for clinical treatment;3.To investigate the correlation between UP and anxiety,depression and sleep,and its impact on quality of life.Methods:A total of 227 MHD patients were enrolled in this cross-sectional study from April to September 2021 in the Hemodialysis Center of Nanchong Central Hospital according to the inclusion and exclusion criteria.General clinical data and relevant laboratory indicators of the patients were collected.the 5-D itch scale(5D-IS)was used to assess the degree of itching,and the hospital used the hospital anxiety and depression scale(HADS)to quantify anxiety and depression.Sleep is assessed on the Athens insomnia scale(AIS).SPSS25.0 statistical software was used for statistical analysis.The general clinical data,laboratory indicators and scale data(5D-IS,HADS,AIS)of MHD patients were univariate analysis,and the differences among various indicators of MHD patients between different groups were compared.Binary Logistic regression analysis was performed on the relevant factors with statistically significant differences in the univariate analysis to analyze the influencing factors and risk factors related to the occurrence of UP.And the correlation between UP and anxiety,depression and sleep was discussed to assess the impact on patients’ quality of life.Results:1.A total of 227 MHD patients met the inclusion criteria,among the 227 MHD patients,153 had UP(prevalence rate 67.4%),125 were male(55.1%),102 were female(44.9%),73 were aged 65 years or older(32.2%),and 154 were younger than 65 years old(67.8%).The median age of dialysis was 36 months.There were 74 patients(32.6%)without pruritus,153 patients(67.4%)with pruritus,73 patients(32.2%)with mild pruritus,74 patients(32.6%)with moderate pruritus,and 6 patients(2.6%)with severe pruritus.2.Patients with UP in MHD had higher serum values in age,C-reactive protein(CRP),serum creatinine(SCr),serum cystatin C(YS-C),and triglycerides(TG)than those without pruritus(P<0.05);However,the differences of age,serum inorganic phosphorus(IP)and CRP were statistically significant among patients with different itching degree of UP(P<0.05),multiple comparisons between groups showed that age and CRP were higher in severe pruritus group than in mild pruritus group(P<0.05);IP in moderate pruritus group was higher than that in severe pruritus group(P<0.05);Binary Logistic regression analysis showed that old age,high SCr,high Cys-C and high TG levels were independent risk factors for UP in MHD patients.3.In the correlation analysis between UP and anxiety,depression and sleep in MHD patients,there was a very weak positive correlation between 5D-IS score and HADS anxiety score in MHD patients(r=0.137,P=0.04),which is there was a very weak positive correlation between pruritus and anxiety in MHD patients and a weak positive correlation with AIS score(r=0.308,P<0.001),which is there was a weak positive correlation between pruritus and insomnia in MHD patients.Conclusion:1.The prevalence rate of UP in MHD patients in our center is relatively high;2.Age,CRP,SCr,Cys-C and TG levels were related factors for the occurrence of UP,and old age,high SCr,high Cys-C and high TG levels were independent risk factors for the occurrence of UP.3.There is a very weak positive correlation between UP and anxiety in MHD patients,and a weak positive correlation between UP and insomnia,that is,MHD patients with UP are more prone to anxiety and insomnia,so the itchy skin of MHD patients will negatively affect their quality of life. |
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