Clinical Assessment and Risk Factors of Uremic Pruritus among Hemodialysis Patients

N. Besely, Wafaa; Abd El Gawad Ali Rabie, Emad; Aly Maharem, Dalia; Fathy Amr, Eman

doi:10.21608/ejhc.2024.384697

Clinical Assessment and Risk Factors of Uremic Pruritus among Hemodialysis Patients

Document Type : Original Article

Authors

¹ Assistant Professor of Medical-Surgical Nursing, Faculty of Nursing, Alexandria University

² Lecturer of Medical-Surgical Nursing, Faculty of Nursing, Alexandria University

³ Assistant Professor of Internal Medicine, Medical Research Institute, Alexandria University

⁴ Assistant Professor of Medical-Surgical Nursing, Faculty of Nursing, Beni Suef University

10.21608/ejhc.2024.384697

Abstract

Background: Hemodialysis patients usually suffer from debilitating physical and psychological symptoms that negatively impact their life. Uremic pruritus is a frequent complaint of this group of patients. The pathophysiology of uremic pruritus is still not known and is supposed to be a multifactorial problem. Aims: To identify the clinical assessment and risk factors of uremic pruritus among hemodialysis patients. Study Design: A descriptive research design was utilized in current study. Setting: This study was carried out at the hemodialysis units of El Mowasah Hospital, Sharq El Madina Hospital, The Medical Research Institute Hospital, and El Shefaa Hospital in Alexandria Governorate, in addition to University Hospital in Beni Suef Governorate, in Egypt. Subjects: A convenience sample of 215 hemodialysis patients with uremic pruritus was recruited. Tools: Two tools were used for data collection. Tool I: Uremic Pruritus Structured Interview Questionnaire, it was composed of four parts. Part I: Patient’s Socio-demographic Data; Part II: Patient’s Clinical Data; Part III: Characteristics of Patient’s Hygienic Pattern; and Part IV: Patient’s Laboratory Investigations. Tool II: 5-D Pruritus Scale which included five domains namely duration, degree, direction, disability and distribution of pruritus. Results: There were significant relationships between socio-demographics and pruritus condition of the patients (where P for age = 0.002, level of education = 0.010 and place of residence = 0.001). Patterns of patients’ hygiene had significant relationship with the degree of pruritus concerning use of emollients (P = 0.039),clothing materials (P = 0.004), and bedding materials (P = 0.045). Conclusion: The study findings emphasize the significance of conducting clinical assessments that reflect multiple dimensions to discover and identify risk factors of uremic pruritus among hemodialysis patients and advocate establishing standardized and patient-specific approaches for such symptom management. The identified risk factors of the present study are increased duration of the dialysis (more than five years), dryness of patients’ skin, and increased concentration of blood urea & creatinine, as well as calcium levels. Recommendations: Plan and hold an educational program for both hemodialysis patients and nurses on risk factors and management of uremic pruritus.

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