ArticleKidney medicine2026
Chronic Kidney Disease-Associated Pruritus in Danish Dialysis Patients: A Cross-Sectional Multicenter Study of Prevalence, Disease Burden, and Current Treatment Practices.
Article in Kidney medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Rationale & Objective: Chronic kidney disease-associated pruritus (CKD-aP) is rarely systematically assessed despite the potential negative impact on quality of life (QoL). This study investigated prevalence, disease burden, physician awareness, and treatment practices. Study Design: Multicenter cross-sectional study using patient-reported outcome measures and a physician practice survey. Setting & Population: Adult patients with chronic kidney failure requiring replacement therapy and nephrologists from 8 Danish hospitals. Exposure: Kidney failure requiring replacement therapy and dialysis modality. Outcomes: CKD-aP prevalence (score, >4) and pruritus severity (range, 0-10) according to the Worst Itch Numeric Rating Scale (WI-NRS). QoL and skin distribution assessed with the 5-D itch scale (range, 5-25). Physician awareness and treatment practices (self-invented questionnaire). Analytical Approach: Descriptive statistics were used. Results: We recruited 642 patients (∼25% of the Danish dialysis population): 83% receiving hemodialysis (HD), 13% receiving peritoneal dialysis, and 4% receiving home HD (HHD). The median WI-NRS score (IQR) was 0 (0-4). CKD-aP prevalence (95% CI) was 21% (18%-24%) (WI-NRS, >4). Moderate to very severe pruritus (WI-NRS, ≥4) was found in 25% (19%-32%). The median 5-D score (IQR) was 5 (5-10) (all patients). Peritoneal dialysis patients had significantly higher WI-NRS and 5-D scores than HD and HHD patients. Overall, the impact of CKD-aP on daily activities was minimal, but sleep disability (score, >1) was found in 20%. Sleep disability correlated significantly with higher WI-NRS scores. Based on 75 questionnaires (nephrologists/residents: 46/25), most physicians overestimated CKD-aP prevalence and favored dialysis, and fatty cream and phosphate-lowering treatment, rather than systemic treatment with gabapentinoids or difelikefalin. Limitations: Single time-point estimate of CKD-aP and few HHD patients. No dermatologic evaluation was performed to exclude other pruritic conditions. Conclusions: About 1 of 5 to 1 of 4 dialysis patients had CKD-aP, which mainly impaired QoL via sleep disturbance. Physicians demonstrated adequate awareness, but treatment remained largely limited to dialysis and fatty cream. Simple patient-reported outcome measures facilitated systematic assessment.
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