Effect of residual kidney function and dialysis adequacy on chronic pruritus in dialysis patients

Robin Lengton; Esmee M van der Willik; Esther N M de Rooij; Yvette Meuleman; Saskia Le Cessie; Wieneke M Michels; Marc Hemmelder; Friedo W Dekker; Ellen K Hoogeveen; Netherlands Cooperative Study on the Adequacy of Dialysis-2 (NECOSAD) Study Group

doi:10.1093/ndt/gfac341

Effect of residual kidney function and dialysis adequacy on chronic pruritus in dialysis patients

Robin Lengton^*, Esmee M van der Willik, Esther N M de Rooij, Yvette Meuleman, Saskia Le Cessie, Wieneke M Michels, Marc Hemmelder, Friedo W Dekker, Ellen K Hoogeveen, Netherlands Cooperative Study on the Adequacy of Dialysis-2 (NECOSAD) Study Group

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Chronic Kidney Disease-associated pruritus (CKD-aP) is common in dialysis patients, associated with lower quality of life and increased risk of death. We investigated the association between residual eGFR, dialysis adequacy or serum phosphate level and CKD-aP in incident dialysis patients.

METHODS: 1256 incident hemodialysis (HD) and 670 peritoneal dialysis (PD) patients (>18y) from the Netherlands Cooperative Study on the Adequacy of Dialysis study were included (1997-2007) and followed until death, transplantation, or max 10y. CKD-aP was measured using a single item of the KDQOL-36. The associations were studied by logistic and linear regression analyses, adjusted for potential baseline confounders.

RESULTS: At baseline mean (SD) age was 60 (16), 62% were men and median (IQR) residual eGFR was 3.4 (1.7-5.3) ml/min/1.73m2. The prevalence of CKD-aP (∼70%) was similar in HD and PD. It was observed that 12 months after starting dialysis (after multivariable adjustment) each 1 ml/min/1.73m2 higher residual eGFR, one unit higher total weekly Kt/V, or 1 mmol/L lower serum phosphate level was associated with lower burden of CKD-aP in HD and PD patients of -0.05 (95%CI:-0.09;-0.02) and -0.09 (95%CI:-0.13;-0.05), -0.15 (95%CI:-0.26;-0.05) and -0.35 (95%CI:-0.54;-0.16), and of -0.34 (95%CI:-0.17;-0.51) and -0.45 (95%CI:-0.19;-0.71), respectively. We found no association between dialysis Kt/V and CKD-aP.

CONCLUSIONS: Higher residual eGFR and lower serum phosphate level, but not the dialysis dose, were related with lower burden of CKD-aP in dialysis patients.

Original language	English
Pages (from-to)	1508-1518
Number of pages	11
Journal	Nephrology Dialysis Transplantation
Volume	38
Issue number	6
Early online date	22 Dec 2022
DOIs	https://doi.org/10.1093/ndt/gfac341
Publication status	Published - 31 May 2023

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Lengton, R., van der Willik, E. M., de Rooij, E. N. M., Meuleman, Y., Cessie, S. L., Michels, W. M., Hemmelder, M., Dekker, F. W., Hoogeveen, E. K., & Netherlands Cooperative Study on the Adequacy of Dialysis-2 (NECOSAD) Study Group (2023). Effect of residual kidney function and dialysis adequacy on chronic pruritus in dialysis patients. Nephrology Dialysis Transplantation, 38(6), 1508-1518. https://doi.org/10.1093/ndt/gfac341

@article{e7a93fab87b8424f9a99465b4fe1bb58,

title = "Effect of residual kidney function and dialysis adequacy on chronic pruritus in dialysis patients",

abstract = "BACKGROUND: Chronic Kidney Disease-associated pruritus (CKD-aP) is common in dialysis patients, associated with lower quality of life and increased risk of death. We investigated the association between residual eGFR, dialysis adequacy or serum phosphate level and CKD-aP in incident dialysis patients.METHODS: 1256 incident hemodialysis (HD) and 670 peritoneal dialysis (PD) patients (>18y) from the Netherlands Cooperative Study on the Adequacy of Dialysis study were included (1997-2007) and followed until death, transplantation, or max 10y. CKD-aP was measured using a single item of the KDQOL-36. The associations were studied by logistic and linear regression analyses, adjusted for potential baseline confounders.RESULTS: At baseline mean (SD) age was 60 (16), 62% were men and median (IQR) residual eGFR was 3.4 (1.7-5.3) ml/min/1.73m2. The prevalence of CKD-aP (∼70%) was similar in HD and PD. It was observed that 12 months after starting dialysis (after multivariable adjustment) each 1 ml/min/1.73m2 higher residual eGFR, one unit higher total weekly Kt/V, or 1 mmol/L lower serum phosphate level was associated with lower burden of CKD-aP in HD and PD patients of -0.05 (95%CI:-0.09;-0.02) and -0.09 (95%CI:-0.13;-0.05), -0.15 (95%CI:-0.26;-0.05) and -0.35 (95%CI:-0.54;-0.16), and of -0.34 (95%CI:-0.17;-0.51) and -0.45 (95%CI:-0.19;-0.71), respectively. We found no association between dialysis Kt/V and CKD-aP.CONCLUSIONS: Higher residual eGFR and lower serum phosphate level, but not the dialysis dose, were related with lower burden of CKD-aP in dialysis patients.",

author = "Robin Lengton and {van der Willik}, {Esmee M} and {de Rooij}, {Esther N M} and Yvette Meuleman and Cessie, {Saskia Le} and Michels, {Wieneke M} and Marc Hemmelder and Dekker, {Friedo W} and Hoogeveen, {Ellen K} and {Netherlands Cooperative Study on the Adequacy of Dialysis-2 (NECOSAD) Study Group}",

note = "{\textcopyright} The Author(s) 2022. Published by Oxford University Press on behalf of the ERA.",

year = "2023",

month = may,

day = "31",

doi = "10.1093/ndt/gfac341",

language = "English",

volume = "38",

pages = "1508--1518",

journal = "Nephrology Dialysis Transplantation",

issn = "0931-0509",

publisher = "Oxford University Press",

number = "6",

}

Lengton, R, van der Willik, EM, de Rooij, ENM, Meuleman, Y, Cessie, SL, Michels, WM, Hemmelder, M, Dekker, FW, Hoogeveen, EK & Netherlands Cooperative Study on the Adequacy of Dialysis-2 (NECOSAD) Study Group 2023, 'Effect of residual kidney function and dialysis adequacy on chronic pruritus in dialysis patients', Nephrology Dialysis Transplantation, vol. 38, no. 6, pp. 1508-1518. https://doi.org/10.1093/ndt/gfac341

TY - JOUR

T1 - Effect of residual kidney function and dialysis adequacy on chronic pruritus in dialysis patients

AU - Lengton, Robin

AU - van der Willik, Esmee M

AU - de Rooij, Esther N M

AU - Meuleman, Yvette

AU - Cessie, Saskia Le

AU - Michels, Wieneke M

AU - Hemmelder, Marc

AU - Dekker, Friedo W

AU - Hoogeveen, Ellen K

AU - Netherlands Cooperative Study on the Adequacy of Dialysis-2 (NECOSAD) Study Group

PY - 2023/5/31

Y1 - 2023/5/31

N2 - BACKGROUND: Chronic Kidney Disease-associated pruritus (CKD-aP) is common in dialysis patients, associated with lower quality of life and increased risk of death. We investigated the association between residual eGFR, dialysis adequacy or serum phosphate level and CKD-aP in incident dialysis patients.METHODS: 1256 incident hemodialysis (HD) and 670 peritoneal dialysis (PD) patients (>18y) from the Netherlands Cooperative Study on the Adequacy of Dialysis study were included (1997-2007) and followed until death, transplantation, or max 10y. CKD-aP was measured using a single item of the KDQOL-36. The associations were studied by logistic and linear regression analyses, adjusted for potential baseline confounders.RESULTS: At baseline mean (SD) age was 60 (16), 62% were men and median (IQR) residual eGFR was 3.4 (1.7-5.3) ml/min/1.73m2. The prevalence of CKD-aP (∼70%) was similar in HD and PD. It was observed that 12 months after starting dialysis (after multivariable adjustment) each 1 ml/min/1.73m2 higher residual eGFR, one unit higher total weekly Kt/V, or 1 mmol/L lower serum phosphate level was associated with lower burden of CKD-aP in HD and PD patients of -0.05 (95%CI:-0.09;-0.02) and -0.09 (95%CI:-0.13;-0.05), -0.15 (95%CI:-0.26;-0.05) and -0.35 (95%CI:-0.54;-0.16), and of -0.34 (95%CI:-0.17;-0.51) and -0.45 (95%CI:-0.19;-0.71), respectively. We found no association between dialysis Kt/V and CKD-aP.CONCLUSIONS: Higher residual eGFR and lower serum phosphate level, but not the dialysis dose, were related with lower burden of CKD-aP in dialysis patients.

AB - BACKGROUND: Chronic Kidney Disease-associated pruritus (CKD-aP) is common in dialysis patients, associated with lower quality of life and increased risk of death. We investigated the association between residual eGFR, dialysis adequacy or serum phosphate level and CKD-aP in incident dialysis patients.METHODS: 1256 incident hemodialysis (HD) and 670 peritoneal dialysis (PD) patients (>18y) from the Netherlands Cooperative Study on the Adequacy of Dialysis study were included (1997-2007) and followed until death, transplantation, or max 10y. CKD-aP was measured using a single item of the KDQOL-36. The associations were studied by logistic and linear regression analyses, adjusted for potential baseline confounders.RESULTS: At baseline mean (SD) age was 60 (16), 62% were men and median (IQR) residual eGFR was 3.4 (1.7-5.3) ml/min/1.73m2. The prevalence of CKD-aP (∼70%) was similar in HD and PD. It was observed that 12 months after starting dialysis (after multivariable adjustment) each 1 ml/min/1.73m2 higher residual eGFR, one unit higher total weekly Kt/V, or 1 mmol/L lower serum phosphate level was associated with lower burden of CKD-aP in HD and PD patients of -0.05 (95%CI:-0.09;-0.02) and -0.09 (95%CI:-0.13;-0.05), -0.15 (95%CI:-0.26;-0.05) and -0.35 (95%CI:-0.54;-0.16), and of -0.34 (95%CI:-0.17;-0.51) and -0.45 (95%CI:-0.19;-0.71), respectively. We found no association between dialysis Kt/V and CKD-aP.CONCLUSIONS: Higher residual eGFR and lower serum phosphate level, but not the dialysis dose, were related with lower burden of CKD-aP in dialysis patients.

U2 - 10.1093/ndt/gfac341

DO - 10.1093/ndt/gfac341

M3 - Article

C2 - 36549655

SN - 0931-0509

VL - 38

SP - 1508

EP - 1518

JO - Nephrology Dialysis Transplantation

JF - Nephrology Dialysis Transplantation

IS - 6

ER -

Effect of residual kidney function and dialysis adequacy on chronic pruritus in dialysis patients

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