title: Assessment of the psychological burden associated with pruritus in hemodialysis patients using the kidney disease quality of life short form.
abstract: OBJECTIVE
  To assess whether depression symptoms, poor sleep and dry skin bother explain association between pruritus and the burden of kidney disease in maintenance hemodialysis (MHD) patients.
  
  
  METHODS
  Cross-sectional study of 980 patients from a prospective study in dialysis units of Salvador, Brazil (PROHEMO). The Kidney Disease Quality of Life Short Form was used to determine scores of kidney disease burden (KDB) and sleep with higher scores indicating lower perceived burden and better sleep quality, respectively. The Center for Epidemiological Studies Depression Scale was used for depression symptoms.
  
  
  RESULTS
  Prevalence of severe pruritus (very much or extreme) was 19.4%. Significantly (P < 0.001) lower mean KDB score by 11.44 points was observed for patients with severe pruritus (34.18 ± 27.51) than for those with no pruritus (45.62 ± 30.73). Severe pruritus was associated with poorer sleep quality, higher odds of dry skin bother and higher depression symptoms score. Association of pruritus with KDB score was virtually eliminated after adjustment for sleep, dry skin bother and depression symptoms.
  
  
  CONCLUSIONS
  This study shows strong associations of severe pruritus with higher depression symptoms, poorer sleep and dry skin bother among MHD patients. The results support special attention to MHD patients with pruritus who often face high psychological burden.
authors: Núcleo de Epidemiologia Clínica e Medicina Baseada em Evidências, Hospital Universitário Professor Edgar Santos, Universidade Federal da Bahia, Rua Doutor Augusto Viana s/n, Canela, Salvador, BA, 40110-040, Brazil.
authors: Gildete Barreto
authors: GB
authors: Lopes
authors: Fernanda Conceição Pereira
authors: FC
authors: Nogueira
authors: Milena Reis
authors: MR
authors: de Souza
authors: Maria Auxiliadora
authors: MA
authors: Penalva
authors: Josete Leão
authors: JL
authors: de Amorim
authors: Ronald L
authors: RL
authors: Pisoni
authors: Bruce M
authors: BM
authors: Robinson
authors: Antonio Alberto
authors: AA
authors: Lopes
mesh_terms: D000328:Adult; D001938:Brazil; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011537:Pruritus / Q000150:complications / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D006435:Renal Dialysis; D012893:Sleep Wake Disorders / Q000150:complications; D011795:Surveys and Questionnaires