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Pruritus in haemodi...
Pruritus in haemodialysis patients : international results from the Dialysis Outcomes and Practice Patterns Study (DOPPS)
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Pisoni, Ronald L. (författare)
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- Wikström, Björn (författare)
- Uppsala universitet,Institutionen för medicinska vetenskaper
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Elder, Stacey J. (författare)
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Akizawa, Tadao (författare)
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Asano, Yashushi (författare)
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Keen, Marcia L. (författare)
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Saran, Rajiv (författare)
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Mendelssohn, David C. (författare)
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Young, Eric W. (författare)
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Port, Friedrich K. (författare)
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(creator_code:org_t)
- 2006-09-23
- 2006
- Engelska.
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Ingår i: Nephrology, Dialysis and Transplantation. - : Oxford University Press (OUP). - 0931-0509 .- 1460-2385. ; 21:12, s. 3495-3505
- Relaterad länk:
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https://academic.oup...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background. Pruritus affects many haemodialysis (HD) patients. In this study, pruritus and its relationship to morbidity, mortality, quality of life (QoL), sleep quality and patient laboratory measures were analysed in > 300 dialysis units in 12 countries. Methods. Pruritus data were collected from 18 801 HD patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS) (1996-2004). Analyses were adjusted for age, gender, black race, Kt/V, haemoglobin, serum albumin, albumin-corrected serum calcium, serum phosphorus, 13 comorbidities, depression, years on dialysis, country and facility clustering effects. Results. Moderate to extreme pruritus was experienced by 42% of prevalent HD patients in DOPPS during 2002/2003. Many patient characteristics were significantly associated with pruritus, but this did not explain the large differences in pruritus between countries (ranging from 36% in France to 50% in the UK) and between facilities (5-75%). Pruritus was slightly less common in patients starting HD than in patients on dialysis > 3 months. Pruritus in new end-stage renal disease (ESRD) patients likely results from pre-existing conditions and not haemodialysis per se, indicating the need to understand development of pruritus before ESRD. Patients with moderate to extreme pruritus were more likely to feel drained [adjusted odds ratio (AOR) = 2.3-5.2, P < 0.0001] and to have poor sleep quality (AOR = 1.9-4.1, P <= 0.0002), physician-diagnosed depression (AOR = 1.3-1.7, P <= 0.004), and QoL mental and physical composite scores 3.1-8.6 points lower (P < 0.0001) than patients with no/mild pruritus. Pruritus in HD patients was associated with a 17% higher mortality risk (P < 0.0001), which was no longer significant after adjusting for sleep quality measures. Conclusions. The pruritus/mortality relationship may be substantially attributed to poor sleep quality. The many poor outcomes associated with pruritus underscore the need for better therapeutic agents to provide relief for the 40-50% of HD patients affected by pruritus.
Nyckelord
- calcium
- DOPPS
- haemodialysis
- itching
- mortality
- phosphorus
- pruritus
- quality of life
- sleep quality
- MEDICINE
- MEDICIN
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Pisoni, Ronald L ...
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Wikström, Björn
-
Elder, Stacey J.
-
Akizawa, Tadao
-
Asano, Yashushi
-
Keen, Marcia L.
-
visa fler...
-
Saran, Rajiv
-
Mendelssohn, Dav ...
-
Young, Eric W.
-
Port, Friedrich ...
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visa färre...
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Nephrology, Dial ...
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Uppsala universitet