Baris Afsar1, Rengin Elsurer Afsar. 1. Department of Nephrology, Zonguldak Atatürk Government Hospital, Zonguldak, Turkey. afsarbrs@yahoo.com
Abstract
OBJECTIVE: Uremic pruritus (UP) remains a frequent problem in hemodialysis (HD) patients and is related to mortality. Poor glycemic control, as evaluated by hemoglobin A1c (HbA1c), is also associated with morbidity and mortality in HD patients. In this study, we investigated the relationship between UP and HbA1c in HD patients. METHODS: Sociodemographic, clinical, and laboratory variables, depressive symptoms, and health-related quality of life were assessed. Severity of UP was evaluated by visual analogue scale (VAS). The scale consisted of a 10 cm horizontal line marked from 0 (denoting no itch) to 10 (denoting worst possible imaginable itch). RESULTS: Totally, 75 patients (male/female, 41/34; diabetic/nondiabetic, 29/46; age, 51.9 ± 13.5 years) were included. The VAS pruritus score was higher in diabetic patients compared with nondiabetic patients (4.7 ± 2.8 vs. 3.0 ± 1.0, p : 0.015). In diabetics, VAS pruritus score was independently related with calcium-phosphorus product (β : +0.637, p < 0.0001), intact parathyroid hormone (β : +0.343, p : 0.017), HbA1c (β : +0.310, p : 0.027), and Beck depression score (β : +0.474, p : 0.002). In nondiabetics, VAS pruritus score was independently related with calcium-phosphorus product (β : +0.486, p : 0.004), intact parathyroid hormone (β : +0.302, p : 0.041), and HbA1c (β : +0.341, p : 0.033). In the whole patient group, VAS pruritus score was independently related with calcium-phosphorus product (β : +0.372, p : 0.001), intact parathyroid hormone (β : +0.241, p : 0.008), HbA1c (β : +0.227, p : 0.031), and Beck depression score (β : +0.298, p : 0.003). CONCLUSIONS: In both diabetic and nondiabetic patients, HbA1c is closely related with pruritus in HD patients.
OBJECTIVE:Uremic pruritus (UP) remains a frequent problem in hemodialysis (HD) patients and is related to mortality. Poor glycemic control, as evaluated by hemoglobin A1c (HbA1c), is also associated with morbidity and mortality in HDpatients. In this study, we investigated the relationship between UP and HbA1c in HDpatients. METHODS: Sociodemographic, clinical, and laboratory variables, depressive symptoms, and health-related quality of life were assessed. Severity of UP was evaluated by visual analogue scale (VAS). The scale consisted of a 10 cm horizontal line marked from 0 (denoting no itch) to 10 (denoting worst possible imaginable itch). RESULTS: Totally, 75 patients (male/female, 41/34; diabetic/nondiabetic, 29/46; age, 51.9 ± 13.5 years) were included. The VAS pruritus score was higher in diabeticpatients compared with nondiabeticpatients (4.7 ± 2.8 vs. 3.0 ± 1.0, p : 0.015). In diabetics, VAS pruritus score was independently related with calcium-phosphorus product (β : +0.637, p < 0.0001), intact parathyroid hormone (β : +0.343, p : 0.017), HbA1c (β : +0.310, p : 0.027), and Beck depression score (β : +0.474, p : 0.002). In nondiabetics, VAS pruritus score was independently related with calcium-phosphorus product (β : +0.486, p : 0.004), intact parathyroid hormone (β : +0.302, p : 0.041), and HbA1c (β : +0.341, p : 0.033). In the whole patient group, VAS pruritus score was independently related with calcium-phosphorus product (β : +0.372, p : 0.001), intact parathyroid hormone (β : +0.241, p : 0.008), HbA1c (β : +0.227, p : 0.031), and Beck depression score (β : +0.298, p : 0.003). CONCLUSIONS: In both diabetic and nondiabeticpatients, HbA1c is closely related with pruritus in HDpatients.
Authors: Mirosław Snit; Radosław Gawlik; Beata Łącka-Gaździk; Roman Kuźniewicz; Marek Dwornicki; Aleksander Owczarek; Małgorzata Walaszczyk; Piotr Grabiec; Władysław Grzeszczak Journal: Med Sci Monit Date: 2013-09-02