ArticleKidney medicine
Self-reported Pruritus and Clinical, Dialysis-Related, and Patient-Reported Outcomes in Hemodialysis Patients.
Article in Kidney medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 92 papers, 6 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
92 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Association of pruritus with comorbidities and survival in chronic kidney disease: a narrative review of the pre-difelikefalin era literature.Renal failure · 2026Pooled it
- Prevalence and associated factors of chronic kidney disease-associated pruritus in maintenance hemodialysis patients: a systematic review and meta-analysis.BMC nephrology · 2026Pooled it
- Prevalence and influencing factors of pruritus in maintenance hemodialysis patients in China: a meta-analysis.BMC nephrology · 2025Pooled it
- Chronic kidney disease-associated pruritus and patient-centred outcomes: a systematic review.Journal of nephrology · 2025Pooled it
- Efficacy and safety of different systemic drugs in the treatment of uremic pruritus among hemodialysis patients: a network meta-analysis based on randomized clinical trials.Frontiers in medicine · 2024Pooled it
- Difelikefalin in the treatment of hemodialysis patients with pruritus: a systematic review and meta-analysis.Frontiers in pharmacology · 2024Pooled it
- Influence of Concomitant Opioids on Difelikefalin Treatment Outcomes in Adults with Moderate-to-Severe Pruritus on Maintenance Hemodialysis: Exploratory Analyses.Kidney & blood pressure research · 2026Trial
- Psychometric validation and meaningful change thresholds of the Skindex-10 questionnaire and 5-D Itch scale for assessing itch in patients with chronic kidney disease-associated pruritus.Journal of patient-reported outcomes · 2025Trial
- Efficacy and safety of anrikefon in patients with pruritus undergoing haemodialysis: multicentre, double blind, randomised placebo controlled phase 3 trial.BMJ (Clinical research ed.) · 2025Trial
- Influence of Baseline Itch Severity on Treatment Outcomes With Difelikefalin in Adults With Moderate-to-Severe Pruritus Receiving Maintenance Haemodialysis: An Exploratory Analysis.Journal of renal care · 2025Trial
- Difelikefalin improves itch-related sleep disruption in patients undergoing haemodialysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024Trial
- Trial
- Article
- Difelikefalin Treatment in Chronic Kidney Disease-Associated Pruritus: Modelling Infection-Related Hospitalisation Cost Offsets Using Trial and Real-World Data Across Seven European Countries.Advances in therapy · 2026Article
- Real-world effectiveness and tolerability of difelikefalin over 12 months for hemodialysis-associated pruritus.International urology and nephrology · 2026Observational
- Refractory Chronic Kidney Disease-Associated Pruritus: Old Remedies and Novel Agents.Kidney medicine · 2026Article
- Chronic Kidney Disease-Associated Pruritus in Patients on Home Haemodialysis.Nephrology (Carlton, Vic.) · 2026Article
- Gabapentin Utilization and Adverse Effects Among US Hemodialysis Patients Diagnosed With Pruritus or Neuropathic Pain.Kidney medicine · 2026Article
- Difelikefalin in Chinese patients with chronic kidney disease-associated pruritus.Clinical kidney journal · 2026Article
- Assessing Functional Cognition in People on Maintenance Hemodialysis Using Performance-Based Testing.Kidney360 · 2026Article
32 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
RATIONALE &
objectiveChronic kidney disease (CKD)-associated pruritus, generalized itching related to CKD, affects many aspects of hemodialysis patients' lives. However, information regarding the relationship between pruritus and several key outcomes in hemodialysis patients remains limited. STUDY
designProspective cohort. SETTING &
participants23,264 hemodialysis patients from 21 countries in the Dialysis Outcomes and Practice Patterns Study (DOPPS) phases 4 to 6 (2009-2018). EXPOSURE: Pruritus severity, based on self-reported degree to which patients were bothered by itchy skin (5-category ordinal scale from "not at all" to "extremely"). OUTCOMES: Clinical, dialysis-related, and patient-reported outcomes. ANALYTICAL APPROACH: Cox regression for time-to-event outcomes and modified Poisson regression for binary outcomes, adjusted for potential confounders.
resultsThe proportion of patients at least moderately bothered by pruritus was 37%, and 7% were extremely bothered. Compared with the reference group ("not at all"), the adjusted mortality HR for patients extremely bothered by pruritus was 1.24 (95% CI, 1.08-1.41). Rates of cardiovascular and infection-related deaths and hospitalizations were also higher for patients extremely versus not at all bothered by pruritus (HR range, 1.17-1.44). Patients extremely bothered by pruritus were also more likely to withdraw from dialysis and miss hemodialysis sessions and were less likely to be employed. Strong monotonic associations were observed between pruritus severity and longer recovery time from a hemodialysis session, lower physical and mental quality of life, increased depressive symptoms, and poorer sleep quality. LIMITATIONS: Residual confounding, recall bias, nonresponse bias.
conclusionsOur findings demonstrate how diverse and far-reaching poor outcomes are for patients who experience CKD-associated pruritus, specifically those with more severe pruritus. There is need for change in practice patterns internationally to effectively identify and treat patients with pruritus to reduce symptom burden and improve quality of life and possibly even survival.
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