tus in this population are needed. Background Pruritus is common in hemodialysis patients. Less is known about the prevalence and outcomes of pruritus among patients receiving peritoneal dialysis (PD). Herein, we describe the prevalence of pruritus and its associations with patient-reported outcomes (PROs) and mortality/transfer to hemodialysis. Methods We analyzed a multicenter, international cohort of PD patients enrolled in the PD Outcomes and Practice Patterns Study from 2014 to 2022. Pruritus was assessed at entry into the PD Outcomes and Practice Patterns Study with a single-question Likert Scale capturing the extent to which patients were bothered by itch ranging from 1: not at all to 5: extremely. The kidney disease quality of life-36 and the Center for Epidemiological Studies Depression Scale assessed various PROs. Moderate-to-extreme pruritus was defined as a Likert scale score ≥3. The associations of pruritus with PROs were assessed using linear/logistic regression where appropriate. Death or hemodialysis transfer was assessed using multivariable Cox regression models. Results Overall, 5535 patients from eight countries were included; 43% had moderate-to-extreme pruritus which was the highest in Thailand (50%) and the lowest in the United States (33%). The adjusted odds ratios of moderate-to-extreme pruritus were higher for diabetes, low albumin, and elevated phosphorus but lower for residual urine volume (adjusted odds ratio, 0.98 per 200 ml increase in 24-hour urine volume; 95% confidence interval, 0.96 to 1.00; P = 0.05). Patients with extreme pruritus had the lowest mental and physical health component scores and a higher burden of other PROs including restless legs and disturbed sleep. Overall, 921 patients died and 1150 were transferred to hemodialysis. Patients with moderate-to-extreme pruritus were at higher adjusted risk for death or hemodialysis transfer (adjusted hazard ratio, 1.12; 95% confidence interval, 1.02 to 1.23; P = 0.02) with similar point estimates for each subcomponent of the composite outcome. Conclusions Pruritus is highly prevalent in PD and associated with poor health outcomes. Efforts to better identify and manage pruritus should be considered in this population....

中文翻译：

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慢性肾病相关瘙痒症的患病率和结果：腹膜透析结果和实践模式研究的国际结果


此人群中的 TUS 是必需的。背景 瘙痒在血液透析患者中很常见。关于接受腹膜透析 （PD） 的患者瘙痒的患病率和结局知之甚少。在本文中，我们描述了瘙痒的患病率及其与患者报告结果 （PROs） 和死亡率/转为血液透析的相关性。方法 我们分析了 2014 年至 2022 年参加 PD 结果和实践模式研究的多中心、国际 PD 患者队列。在进入 PD 结果和实践模式研究时，使用单问题李克特量表评估瘙痒，该量表捕捉了患者受瘙痒困扰的程度，范围从 1：完全没有到 5：极度。肾脏疾病生活质量 36 和流行病学研究中心抑郁量表评估了各种 PRO。中度至极度瘙痒定义为李克特量表评分 ≥3。在适当的情况下使用线性/logistic 回归评估瘙痒与 PRO 的相关性。使用多变量 Cox 回归模型评估死亡或血液透析转移。结果 共纳入来自 8 个国家的 5535 例患者;43% 的患者患有中度至极度瘙痒，其中泰国最高 （50%），美国最低 （33%）。中度至极度瘙痒的调整比值比对于糖尿病、低白蛋白和高磷较高，但残余尿量较低（调整后的比值比，24 小时尿量每增加 200 毫升 0.98;95% 置信区间，0.96 至 1.00;P = 0.05）。极度瘙痒患者的心理和身体健康成分评分最低，其他 PRO 的负担较高，包括不宁腿和睡眠不安。总体而言，921 例患者死亡，1150 例被转为血液透析。 中度至极度瘙痒患者死亡或血液透析转移的调整风险较高（调整后的风险比，1.12;95% 置信区间，1.02 至 1.23;P = 0.02），对复合结果的每个子分量具有相似的点估计值。结论 瘙痒在 PD 中高度普遍，并与不良健康结果相关。应考虑在该人群中更好地识别和管理瘙痒。