title: Epidemiology and determinants of pruritus in pre-dialysis chronic kidney disease patients.
abstract: OBJECTIVE
  There are only a few small studies investigating chronic kidney disease-associated pruritus (CKD-P) in pre-dialysis chronic kidney disease (CKD). None of these has taken into account the associations of CKD-P with clinical features and laboratory data. We aimed to study prevalence of and clinical and laboratory associates of CKD-P in pre-dialysis CKD patients.
  
  
  METHODS
  A total of 402 consecutive stage 2-5 pre-dialysis CKD patients were included in this cross-sectional study. Pruritus was scored based on visual analog scale (VAS). Demographic and clinical features, comorbidities, smoking status and current medication use were recorded. 25 (OH) Vitamin D, urea, creatinine, uric acid, calcium, phosphorus, intact parathyroid hormone (PTH), magnesium, albumin, C-reactive protein (CRP), complete blood count and differential and other laboratory tests were studied for each participant.
  
  
  RESULTS
  This is the largest study conducted in pre-dialysis population with respect to pruritus and associated factors. The prevalence of CKD-P was 18.9%. Hemoglobin level was significantly lower, and eosinophil count and frequency of xerosis cutis were significantly higher in patients with CKD-P than those of patients without pruritus. However, there was no statistical difference between the pruritus and nonpruritus groups regarding vitamin D, PTH, calcium, phosphorus, neutrophil-to-lymphocyte ratio (NLR) and CRP.
  
  
  CONCLUSIONS
  CKD-P was almost present in one in every five pre-dialysis CKD patients. Interestingly, the prevalence was not affected by the stage of the CKD. For the first time, our results showed a significant association between CKD-P and peripheral eosinophilia and anemia. Besides this, xerosis cutis seems a determinant factor for CKD-P and its severity.
authors.affiliation: Department of Dermatology, Faculty of Medicine, Sakarya University, 54000, Sakarya, Turkey. bernasolakmd@gmail.com.
authors.forename: Berna
authors.initials: B
authors.lastname: Solak
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Sakarya University, Sakarya, Turkey.
authors.forename: Seyyid Bilal
authors.initials: SB
authors.lastname: Acikgoz
authors.affiliation: Division of Nephrology, Faculty of Medicine, Sakarya University, Sakarya, Turkey.
authors.forename: Savas
authors.initials: S
authors.lastname: Sipahi
authors.affiliation: Department of Dermatology, Faculty of Medicine, Sakarya University, 54000, Sakarya, Turkey.
authors.forename: Teoman
authors.initials: T
authors.lastname: Erdem
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D002118:Calcium / Q000097:blood*; D003404:Creatinine / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D010758:Phosphorus / Q000097:blood*; D015995:Prevalence; D011537:Pruritus / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D014421:Turkey / Q000453:epidemiology
chemical_list: D010281:Parathyroid Hormone; D010758:Phosphorus; D002097:C-Reactive Protein; D003404:Creatinine; D002118:Calcium
keywords: Chronic kidney disease; Eosinophil; Hemoglobin; Pre-dialysis; Pruritus; Vitamin D