伴皮肤表现的血液透析相关性瘙痒症  

Hemodialysis-related pruritus and associated cutaneous manifestations

作　　者：Dyachenko P. Shustak A. Rozenman D. 周少娜 

机构地区：[1]Haagana 60,Afula-Ilit 18580,Israel Dr.

出　　处：《世界核心医学期刊文摘（皮肤病学分册）》2006年第10期49-50,共2页Digest of the World Core Medical JOurnals:Dermatology

摘　　要：Background:Uremic pruritus is one of the most common disabling problems in patients with chronic renal failure.Few studies have evaluated itching and cutaneous manifestations in hemodialysis-dependent patients.Objectives:The aim of this prospective study was to identify the prevalence of pruritus and cutaneous changes affecting patients undergoing hemodialysis.Methods:The degree of itching in 70 patients treated at the Haemek Medical Center Hemodialysis Unit,in northern Israel,was scored according to presence and severity.We examined the relationship between the quality of dialysis and the frequency of pruritus,and identified concurrent cutaneous disorders.Results:Pruritus was a common problem in the study cohort and affected 74.3%of hemodialysis patients at some point.The main characteristics of pruritus were a general pattern in 65.7%and mild intensity in 78.3%of observed patients.Duration of hemodialysis varied between 3 months and 13 years.There was no correlation between occurrence of pruritus and demographic or medical parameters(sex,type of kidney disease,regular medications or duration of hemodialysis)of the patients.Higher dialysis efficacy,as expressed bydialyser clearance,volume distribution of area,dialysis duration(Kt/v),may reduce the prevalence of pruritus(P < 0.02).None of the blood and chemical values considered(hemoglobin,creatinine,urea,phosphorus,calcium,albumin,parathormone and alkaline phosphatase)revealed any statistically relevant differences between pruritus groups.The appearance of foot ulcers was different between diabetic and nondiabetic individuals undergoing hemodialysis(P < 0.001).Conclusions:Pruritus is still a common problem in hemodialysis-dependent patients.The prevalence of xerosis and excoriations was high in patients undergoing replacement therapy.Efficient replacement hemodialysis may provide a clinical benefit.Background:Uremic pruritus is one of the most common disabling problems in patients with chronic renal failure.Few studies have evaluated itching and cutaneous manifestations in hemodialysis-dependent patients.Objectives:The aim of this prospective study was to identify the prevalence of pruritus and cutaneous changes affecting patients undergoing hemodialysis.Methods:The degree of itching in 70 patients treated at the Haemek Medical Center Hemodialysis Unit,in northern Israel,was scored according to presence and severity.We examined the relationship between the quality of dialysis and the frequency of pruritus,and identified concurrent cutaneous disorders.Results:Pruritus was a common problem in the study cohort and affected 74.3%of hemodialysis patients at some point.The main characteristics of pruritus were a general pattern in 65.7%and mild intensity in 78.3%of observed patients.Duration of hemodialysis varied between 3 months and 13 years.There was no correlation between occurrence of pruritus and demographic or medical parameters(sex,type of kidney disease,regular medications or duration of hemodialysis)of the patients.Higher dialysis efficacy,as expressed bydialyser clearance,volume distribution of area,dialysis duration(Kt/v),may reduce the prevalence of pruritus(P < 0.02).None of the blood and chemical values considered(hemoglobin,creatinine,urea,phosphorus,calcium,albumin,parathormone and alkaline phosphatase)revealed any statistically relevant differences between pruritus groups.The appearance of foot ulcers was different between diabetic and nondiabetic individuals undergoing hemodialysis(P < 0.001).Conclusions:Pruritus is still a common problem in hemodialysis-dependent patients.The prevalence of xerosis and excoriations was high in patients undergoing replacement therapy.Efficient replacement hemodialysis may provide a clinical benefit.

关 键 词：血液透析 瘙痒症 透析质量 瘙痒程度 慢性肾衰竭 透析器 甲状旁腺激素 足部溃疡 碱性磷酸酶 临床缓 

分 类 号：R459.5[医药卫生—治疗学] R692.5[医药卫生—临床医学]