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).

Secular Trends in the Cost of Immunosuppressants after Solid Organ Transplantation in the United States

Generic medications reduce the lifetime costs of organ transplantation

The priceless gift of a transplanted organ comes with life-long costs of the critical immunosuppressant medications that prevent rejection. Although Medicare provides coverage for these drugs to kidney transplant recipients in the three years following a transplant, many transplant recipients have difficulty affording the related out-of-pocket costs post-transplantation.

Findings of a study conducted by Arbor Research Collaborative for Health indicate the potential of relief for these patients and Medicare. This work by Margaret E. Helmuth and her colleagues was published February 28, 2019, in the Clinical Journal of the American Society of Nephrology (CJASN). They examined cost changes following the introduction of generic variations of two commonly prescribed immunosuppressants and determined that the introduction of generic medications in this class has resulted in substantial savings for transplant patients and Medicare.

Study of self-reported symptom clusters may improve the diagnosis and treatment of women with lower urinary tract disorders

Currently, women with lower urinary tract symptoms (LUTS) are treated according to their most troubling symptom. This approach is not always completely successful, as it does not take into account that patients can have multiple symptoms that respond to different treatments.

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).

The long-term psychosocial impact of liver donation

In order for potential liver donors to be fully informed about the risks of donation, they need to have information about the long-term impacts of donation. Studies have examined liver donors’ long-term medical outcomes, but there have been no analogous studies on long-term psychosocial outcomes. To address this gap, researchers examined data from the Adult to Adult Living Donor Liver Transplantation Cohort Study-2 (A2ALL-2) to learn about clinically significant mental health problems and self-reported physical health problems in the long-term years after liver donation.

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.

What motivates someone to seek treatment for lower urinary tract symptoms?

Lower urinary tract symptoms (LUTS) can have a negative impact on quality of life. Yet not all of those who report having LUTS seek clinical care for their symptoms. In a paper in The Journal of Urology, the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) sought to understand and evaluate reasons why people do or do not seek treatment for LUTS.

The Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN)

In 2012, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) created the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) to address gaps in understanding and treating lower urinary tract symptoms (LUTS). LURN is an interdisciplinary consortium-based cooperative research network made up of six clinical research sites and one data coordinating center that aims to change the way we study and treat patients with LUTS. In a newly published paper in the Journal of Urology, the LURN study team presents an overview of the network’s goals.

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