Chronic Kidney Disease-Associated Pruritus in Haemodialysis: A Mixed-Methods Study of Symptom Burden and Patient Experience.
Gülay Turgay, Çiğdem Özdemir Eler
PMID 42522761WHAT IT FOUND
16.3% of haemodialysis patients had moderate-to-severe itch, with sleep loss, stigma and unsafe self-care.
Patients wanted nurses to ask, assess and document itch routinely.
Key findings
0116.3% of participants had moderate-to-severe pruritus.
02In adjusted analysis, comorbid chronic disease (OR=2.399) and receipt of pruritus education (OR=3.145) were associated with higher odds of moderate-to-severe pruritus, while being married (OR=0.418) was associated with lower odds.
03Patients described itch as disrupting sleep, reducing life satisfaction, causing stigma, and they wanted nurses to monitor it and give practical, individualised care.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Conducted in three Turkish dialysis centres, so practice patterns and patient mix may differ elsewhere. Cross-sectional quantitative phase cannot show what causes or treats pruritus. Of the approximately 520 patients in the centres, 294 were analysed, so non-participants may differ. Self-reported itch and treatment effects may be affected by reporting bias. Participants with psychiatric diagnoses or clinically evident psychiatric conditions were excluded, although depression and anxiety are common in haemodialysis. Qualitative interviews included only 48 patients with moderate-to-severe itch, so views of milder or very severe groups may be missing. The association between pruritus education and higher odds is likely reverse causation, not proof that education worsens itch.
Declared interests
The authors report no funding and no conflicts of interest. ChatGPT was used only for language editing and manuscript refinement, not for data generation, analysis or interpretation.
The easy way to misread this
Do not conclude that pruritus education causes worse itch. The study is cross-sectional, and the authors interpret the higher odds among those who received education as likely reactive care rather than harm.