The High Correlation Between Survey Assessments for Chronic Kidney Disease-Associated Pruritus, and Its Associations with Clinical Outcomes
Abstract
:1. Introduction
- Key Learning Points [3]:
- A high prevalence of CKD-aP was found in a diverse urban cohort.
- There was high correlation between two CKD-aP measures, the WI-NRS and KDQOL Q20.
- Moderate-to-severe CKD-aP was associated with a higher risk of sleep-related problems.
- Potential impact: CKD-aP is a common condition, and is associated with various clinical outcomes. We found a strong correlation between two CKD-aP measures. These results can help to identify patients for CKD-aP treatment.
2. Methods
2.1. Study Design
2.2. Study Population
2.3. Measures
2.4. Outcomes
2.5. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Correlation Between KDQOL and WINRS
3.3. Association with Outcomes
4. Discussion
5. Conclusion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Overall (N = 112) | KDQOL-Q20 Survey 1 (Score < 2), N = 48 (42.9%) | KDQOL-Q20 Survey 1 (Score ≥ 2), N = 64 (57.1%) | p | WI-NRS Survey 1 (Score < 4), N = 65 (58.0%) | WI-NRS Survey 1 (Score ≥ 4), N = 47 (42.0%) | p | |
---|---|---|---|---|---|---|---|
Age, mean ± SD | 57 ± 14 | 56 ± 14 | 59 ± 14 | 0.2 | 56.7 ± 15.7 | 58.2 ± 11.1 | 0.6 |
Sex, N (%) | 0.6 | 0.7 | |||||
Male | 48 (43%) | 22 (45.8) | 26 (40.6) | 29 (44.6) | 19 (40.4) | ||
Female | 64 (57%) | 26 (54.2) | 38 (59.4) | 36 (55.4) | 28 (59.6) | ||
Race/ethnicity, N (%) | 0.4 | 0.8 | |||||
White | 7 (6%) | 4 (8.3) | 3 (4.7) | 5 (7.7) | 2 (4.3) | ||
Black | 61 (54%) | 23 (47.9) | 38 (59.4) | 34 (52.3) | 27 (57.5) | ||
Hispanic | 44 (39%) | 21 (43.8) | 23 (35.9) | 26 (40.0) | 18 (38.3) | ||
Medical history, N (%) | |||||||
Heart disease | 20 (18%) | 9 (18.8) | 11 (17.2) | 0.8 | 12 (18.5) | 8 (17.0) | 0.8 |
Congestive heart failure | 15 (13%) | 7 (14.6) | 8 (12.5) | 0.7 | 9 (13.9) | 6 (12.8) | 0.9 |
Liver disease/cirrhosis | 8 (7%) | 3 (6.3) | 5 (7.8) | 1 | 4 (6.2) | 4 (8.5) | 0.7 |
Diabetes | 43 (38%) | 21 (43.8) | 22 (34.4) | 0.3 | 31 (47.7) | 12 (25.5) | 0.02 |
Hypertension | 92 (82%) | 40 (83.3) | 52 (81.3) | 0.8 | 54 (83.1) | 38 (80.9) | 0.8 |
Stroke | 10 (9%) | 3 (6.3) | 7 (10.9) | 0.5 | 4 (6.2) | 6 (12.8) | 0.3 |
Cancer (current) | 2 (2%) | 0 | 2 (3.1) | 0.5 | 0 | 2 (4.3) | 0.2 |
Cancer (past) | 13 (12%) | 4 (8.3) | 9 (14.1) | 0.4 | 4 (6.2) | 9 (19.2) | 0.04 |
Depression | 15 (13%) | 6 (12.5) | 9 (14.1) | 0.8 | 8 (12.3) | 7 (14.9) | 0.7 |
Laboratory values, median (IQR) | |||||||
Hemoglobin g/dL | 10.3 (9.4–11.1) | 10.3 (9.6–11.1) | 10.4 (9.2–11.2) | 0.7 | 10.4 (9.5–11.1) | 10.3 (9.1–11.1) | 0.4 |
Serum albumin (g/dL) | 3.9 (3.7–4.1) | 3.9 (3.7–4.1) | 3.9 (3.7–4.1) | 0.8 | 3.9 (3.6–4.1) | 3.9 (3.7–4.1) | 0.5 |
Calcium (mg/dL) | 9.1 (8.7–9.4) | 9.2 (8.7–9.5) | 9.1 (8.6–9.4) | 0.4 | 9.2 (8.7–9.7) | 9 (8.5–9.4) | 0.1 |
Phosphorus (mg/dL) | 5.7 (4.75–7.0) | 5.6 (4.5–7.0) | 5.8 (5.0–7.0) | 0.3 | 5.6 (4.8–7.0) | 5.9 (4.7–7.0) | 0.4 |
BUN 1 | 64 (51–73) | 62 (51–76) | 64 (51–72) | 0.9 | 63 (52–74) | 64 (49–72) | 0.9 |
Transferrin saturation | 30 (25–38) | 30 (25–38) | 30 (24–39) | 0.8 | 30 (26–38) | 29 (23–40) | 0.8 |
Ferritin | 731 (584–891) | 738 (520–934) | 721 (615–840) | 0.8 | 734 (574–922) | 727 (604–797) | 0.6 |
PTH intact | 482(294–926) | 405 (195–791) | 610 (312–941) | 0.1 | 406 (258–838) | 629 (336–991) | 0.04 |
Kt/V (Daugirdas) | 1.5 (1.3–1.6) | 1.5 (1.3–1.6) | 1.4 (1.3–1.7) | 0.7 | 1.5 (1.3–1.6) | 1.5 (1.3–1.7) | 0.9 |
STDKT/V | 2.2 (2.1–2.3) | 2.2 (2.1–2.3) | 2.2 (2.1–2.3) | 0.4 | 2.2 (2.1–2.3) | 2.2 (2.1–2.3) | 0.9 |
Medications, N (%) | |||||||
Hypertension medications | |||||||
Beta blockers | 49 (44%) | 20 (41.7) | 29 (45.3) | 0.7 | 27 (41.5) | 22 (46.8) | 0.6 |
ACEI/ARB 2 | 20 (18%) | 12 (25.0) | 8 (12.5) | 0.1 | 12 (18.5) | 8 (17.0) | 0.8 |
Calcium channel blockers | 46 (41%) | 24 (50.0) | 22 (34.4) | 0.1 | 31 (47.7) | 15 (31.9) | 0.1 |
Diuretics | 12 (11%) | 3 (6.3) | 9 (14.1) | 0.2 | 7 (10.8) | 5 (10.6) | 1.0 |
Other antihypertensive | 14 (13%) | 6 (12.5) | 8 (12.5) | 1 | 7 (10.8) | 7 (14.9) | 0.5 |
Hyperphosphatemia medications | |||||||
None | 32 (29) | 16 (33.3) | 16 (25.0) | 0.3 | 22 (33.9) | 10 (21.3) | 0.1 |
Sevelamer carbonate | 50 (45%) | 17 (35.4) | 33 (51.6) | 0.1 | 25 (38.5) | 25 (53.2) | 0.1 |
Calcium acetate | 33 (29%) | 16 (33.3) | 17 (26.6) | 0.4 | 19 (29.2) | 14 (29.8) | 0.9 |
Other medications | |||||||
Gabapentin | 16 (14%) | 9 (18.8) | 7 (10.9) | 0.2 | 8 (12.3) | 8 (17.0) | 0.5 |
IV iron in past 30 days | 64 (57%) | 28 (58.3) | 36 (56.3) | 0.8 | 36 (55.4) | 28 (59.6) | 0.7 |
Oral Benadryl | 17 (15%) | 2 (4) | 15 (23) | 0.01 | 4 (6.2) | 13 (27.7) | 0.003 |
CKD-aP by KDQOL-Q20 | Unadjusted RR | Adjusted RR ^ | CKD-aP by WI-NRS | Unadjusted RR | Adjusted RR ^ |
---|---|---|---|---|---|
Outcome: missed HD treatments (≥1 missed HD treatment in 4 weeks) | |||||
Mild CKD-aP | REF | Mild CKD-aP | REF | ||
Moderate/severe CKD-aP | 0.6 (0.3–1.1) | 0.6 (0.3–1.1) | Moderate/severe CKD-aP | 0.8 (0.4–1.5) | 0.8 (0.4–1.5) |
Outcome: depression (PDQ9 >4 (mild-to-severe depression) | |||||
Mild CKD-aP | REF | Mild CKD-aP | REF | ||
Moderate/severe CKD-aP | 1.4 (0.8–2.4) | 1.5 (0.9–2.5) | Moderate/severe CKD-aP | 1.1 (0.7–1.9) | 1.2 (0.7–1.9) |
Outcome: sleep (answering positive to any of three sleep disturbance questions) | |||||
Mild CKD-aP | REF | Mild CKD-aP | REF | ||
Moderate/severe CKD-aP | 1.7 (1.2–2.3) | 1.7 (1.3–2.4) | Moderate/severe CKD-aP | 1.4 (1.1–1.8) | 1.4 (1.1–1.8) |
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Wen, H.H.; Chauhan, K.; Coca, S.; Oliveira, J.; Desai, T.; Huff, K.; Chan, L. The High Correlation Between Survey Assessments for Chronic Kidney Disease-Associated Pruritus, and Its Associations with Clinical Outcomes. Kidney Dial. 2025, 5, 14. https://doi.org/10.3390/kidneydial5020014
Wen HH, Chauhan K, Coca S, Oliveira J, Desai T, Huff K, Chan L. The High Correlation Between Survey Assessments for Chronic Kidney Disease-Associated Pruritus, and Its Associations with Clinical Outcomes. Kidney and Dialysis. 2025; 5(2):14. https://doi.org/10.3390/kidneydial5020014
Chicago/Turabian StyleWen, Huei Hsun, Kinsuk Chauhan, Steven Coca, Juliana Oliveira, Tejas Desai, Keith Huff, and Lili Chan. 2025. "The High Correlation Between Survey Assessments for Chronic Kidney Disease-Associated Pruritus, and Its Associations with Clinical Outcomes" Kidney and Dialysis 5, no. 2: 14. https://doi.org/10.3390/kidneydial5020014
APA StyleWen, H. H., Chauhan, K., Coca, S., Oliveira, J., Desai, T., Huff, K., & Chan, L. (2025). The High Correlation Between Survey Assessments for Chronic Kidney Disease-Associated Pruritus, and Its Associations with Clinical Outcomes. Kidney and Dialysis, 5(2), 14. https://doi.org/10.3390/kidneydial5020014