The Experience of Pruritus in CKD

How distress from itchy skin impacts patient health and quality of life

Recent findings from the Chronic Kidney Disease Outcomes and Practice Patterns Study (CKDopps) advance our knowledge of the patient experience of pruritus, or itchy skin earlier in the lifecycle of kidney disease. This study demonstrates the high prevalence of pruritus and it's strong relationship to the quality of life, poor sleep, and symptoms of depression. Check out the work of Nidhi Sukul, MD and CKDopps collaborators in Clinical Journal of the American Society of Nephrology (CJASN).

Optimal IV iron dosing to manage anemia in hemodialysis patients

Almost all patients on hemodialysis experience anemia, a deficiency of red blood cells causing fatigue and weakness. For over two decades, nephrologists have treated anemia in hemodialysis patients with erythropoiesis-stimulating agents (ESAs) and intravenous (IV) iron. However, there is currently no consensus on the optimal IV iron dose to raise or sustain hemoglobin at appropriate levels, without very high ferritin or TSAT levels and without excessive use of ESAs.

Severe skin itching remains a problem for hemodialysis patients

Pruritus, severe and chronic itching of the skin, is common in people with chronic kidney disease. While mild pruritus may be a nuisance, severe pruritus has a major negative effect on patients’ lives. They are often bothered by the dryness and appearance of their skin and are annoyed by their itching, which has a considerable impact on their social and working lives. Many also suffer restless sleep, which is associated with depression and increased mortality. In a recent paper, investigators studied the prevalence, awareness, and treatment of pruritus to assess how well this important condition is currently managed internationally.

Successful use & placement of arteriovenous fistula (AVF) vascular accesses: US AVF placement trend of concern

People who receive chronic hemodialysis depend on a functional vascular access to allow use of this predominant form of treatment for end stage kidney failure. Vascular access practice varies greatly internationally, with better outcomes typically seen when using an arteriovenous fistula (AVF). Generally, placing the AVF in the lower arm is preferred as there is less risk of exhausting available sites for future AVFs. Given the large international variation in vascular access practice and outcomes, researchers sought to further understand international differences by examining data from the Dialysis Outcomes and Practice Patterns Study (DOPPS).

Starting sevelamer may reduce mortality risk among hemodialysis patients treated with calcium-based phosphate binders

People with end-stage renal disease often have abnormally high levels of phosphorus in their blood, which raises their risk of cardiovascular disease and mortality. For many years, the standard treatment to control phosphorus levels was calcium-based phosphate binders, but these have been linked to arterial calcification.

Hemodiafiltration vs. hemodialysis: Comparing mortality risk

In standard low flux hemodialysis (HD), toxins composed of large molecules are not cleared from the blood as effectively as toxins composed of small molecules. Hemodiafiltration (HDF) uses a greater volume of fluid to clear more molecules of larger size compared to both low flux and high flux HD. Although there is a widespread notion that HDF provides better patient survival than HD, results of previous studies have been mixed.

The Dialysis Outcomes and Practice Patterns Study (DOPPS) expands into Russia

There is little comparable information about hemodialysis practices in low- and middle income countries, including Russia. Previously, Russian hemodialysis practices were reflected only in national reports based on voluntary provision of limited individual-level data from dialysis facilities, and available only in the Russian language.

Interdialytic weight gain and patient outcomes in the DOPPS

High interdialytic weight gain (IDWG) is associated with adverse outcomes in hemodialysis patients. In a recent paper published in the American Journal of Kidney Diseases, researchers used data from the Dialysis Outcomes and Practice Patterns Study (DOPPS) to identify trends in IDWG, predictors of IDWG, and associations of IDWG with clinical outcomes.

First report of Dialysis Outcomes and Practice Patterns Study (DOPPS) data from Turkey

Turkey has one of the largest treated end-stage renal disease (ESRD) patient populations in Europe. In 2013, the international Dialysis Outcomes and Practice Patterns Study (DOPPS), a prospective study of hemodialysis practices and outcomes, began collecting data in Turkey. In a recent paper in Hemodialysis International, researchers compared this data with DOPPS data from other countries and with data from the Registry of Turkish Nephrology, Dialysis and Transplantation.

Validating the Coping Strategies Inventory-Short Form for international study

People living with end-stage renal disease (ESRD) experience many physical and psychological burdens, and they must find coping strategies to deal with these stressors. Researchers in the international Dialysis Outcomes and Practice Patterns Study (DOPPS) wanted to describe the coping strategies used by hemodialysis patients internationally using the Coping Strategies Inventory-Short Form (CSI-SF), but they first needed to study the psychometric properties of this instrument. In a recent paper in the Journal of Psychosomatic Research, they discuss the reliability and validity of the CSI-SF in a large, diverse sample of hemodialysis patients in 13 countries.


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