The Comparison of Renal Osteodystrophy Indices in Hemodialysis Patients with and without Pruritus

比较伴有和不伴有瘙痒的血液透析患者的肾性骨营养不良指数

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Abstract

BACKGROUND: Hemodialysis (HD) patients frequently experience uremic pruritus, a condition that is both irritating and prevalent. Although its pathogenesis is not entirely understood, it is believed to be multifactorial. The objective of this investigation was to evaluate the renal osteodystrophy indices in patients undergoing hemodialysis with and without pruritus. METHODS: This cross-sectional study categorized HD patients in 3 university hospitals in Mashhad, northeast Iran, during 2022 and 2023 into 2 groups: those with and those without pruritus, as determined by the diagnostic criteria. The visual analog scale parameter was employed to evaluate the severity of pruritus. Each patient's blood urea nitrogen, creatinine, calcium, phosphorus, and intact parathyroid hormone (iPTH) levels were evaluated. The data were analyzed using SPSS software Version 16. An independent sample t test and the Mann-Whitney U test, as well as the Spearman correlation test, were used for analysis. RESULTS: A total of 120 participants with a mean age of 57.91 ± 16.03 years were included in the study. The findings showed that the mean blood levels of calcium (P < 0.001), phosphorus (P < 0.001), creatinine (P < 0.001), alkaline phosphatase (P = 0.002), and calcium phosphate product (P < 0.001) were significantly higher in the pruritic group. However, the mean blood urea nitrogen (P = 0.458) and iPTH levels (P = 0.139) did not differ significantly between the 2 groups, but there was a significant relationship between iPTH level and the severity of pruritus (P < 0.001). CONCLUSION: The itching severity in HD patients is substantially correlated with their iPTH levels, and the majority of the indices of renal osteodystrophy are significantly higher in patients with this complication. However, additional studies are suggested.

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