Chronic Kidney Disease-Associated Pruritus in Haemodialysis: A Mixed-Methods Study of Symptom Burden and Patient Experience

IF 2 4区医学 Q3 NURSING

Journal of renal care Pub Date : 2026-07-29 DOI:10.1111/jorc.70075

Gülay Turgay, Çiğdem Özdemir Eler

{"title":"Chronic Kidney Disease-Associated Pruritus in Haemodialysis: A Mixed-Methods Study of Symptom Burden and Patient Experience","authors":"Gülay Turgay, Çiğdem Özdemir Eler","doi":"10.1111/jorc.70075","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Chronic kidney disease-associated pruritus is a common and often under-recognized symptom among people receiving haemodialysis and may substantially impair daily life and wellbeing.</p>\n </section>\n \n <section>\n \n <h3> Objectives</h3>\n \n <p>To determine the prevalence and severity of pruritus in people receiving haemodialysis and to explore the lived experiences of those with moderate-to-severe pruritus.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>Explanatory sequential mixed-methods study.</p>\n </section>\n \n <section>\n \n <h3> Participants</h3>\n \n <p>A total of 294 adults receiving haemodialysis in three dialysis centres participated in the quantitative phase. The qualitative phase included 48 participants selected from the quantitative sample who had moderate-to-severe pruritus, defined as a Five-D Itch Scale score of 12 or higher.</p>\n </section>\n \n <section>\n \n <h3> Measurements</h3>\n \n <p>Data were collected between October 2025 and January 2026. Quantitative data were collected using the Five-Dimensional Itch Scale and a sociodemographic and clinical information form developed for this study. Qualitative data were generated through at least two semi-structured interviews with each participant and analysed using reflexive thematic analysis. Integration was performed at the interpretation stage.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The mean Five-Dimensional Itch Scale score was 8.00 ± 3.21, and moderate-to-severe pruritus prevalence was 16.3%. Multivariable analysis showed lower symptom reporting among married participants, whereas comorbidity and previous pruritus-related education were associated with higher symptom reporting. Qualitative findings indicated that pruritus was experienced as a fluctuating burden affecting sleep, daily comfort, and social roles. Participants described trial-and-error self-management strategies and expressed a need for proactive assessment, practical guidance and individualised nursing care.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Chronic kidney disease-associated pruritus remains a multidimensional burden in haemodialysis care. Standardised assessment and person-centred nursing care may improve its recognition and management.</p>\n </section>\n </div>","PeriodicalId":16947,"journal":{"name":"Journal of renal care","volume":"52 3","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jorc.70075","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of renal care","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jorc.70075","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NURSING","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Chronic kidney disease-associated pruritus is a common and often under-recognized symptom among people receiving haemodialysis and may substantially impair daily life and wellbeing.

Objectives

To determine the prevalence and severity of pruritus in people receiving haemodialysis and to explore the lived experiences of those with moderate-to-severe pruritus.

Design

Explanatory sequential mixed-methods study.

Participants

A total of 294 adults receiving haemodialysis in three dialysis centres participated in the quantitative phase. The qualitative phase included 48 participants selected from the quantitative sample who had moderate-to-severe pruritus, defined as a Five-D Itch Scale score of 12 or higher.

Measurements

Data were collected between October 2025 and January 2026. Quantitative data were collected using the Five-Dimensional Itch Scale and a sociodemographic and clinical information form developed for this study. Qualitative data were generated through at least two semi-structured interviews with each participant and analysed using reflexive thematic analysis. Integration was performed at the interpretation stage.

Results

The mean Five-Dimensional Itch Scale score was 8.00 ± 3.21, and moderate-to-severe pruritus prevalence was 16.3%. Multivariable analysis showed lower symptom reporting among married participants, whereas comorbidity and previous pruritus-related education were associated with higher symptom reporting. Qualitative findings indicated that pruritus was experienced as a fluctuating burden affecting sleep, daily comfort, and social roles. Participants described trial-and-error self-management strategies and expressed a need for proactive assessment, practical guidance and individualised nursing care.

Conclusions

Chronic kidney disease-associated pruritus remains a multidimensional burden in haemodialysis care. Standardised assessment and person-centred nursing care may improve its recognition and management.

查看原文本刊更多论文

血液透析中的慢性肾病相关性瘙痒：症状负担和患者体验的混合方法研究。

背景：慢性肾脏疾病相关性瘙痒是血液透析患者常见但常被忽视的症状，可能严重影响日常生活和健康。目的：确定血液透析患者瘙痒的患病率和严重程度，并探讨中重度瘙痒患者的生活经历。设计：解释性顺序混合方法研究。参与者：共有294名在三个透析中心接受血液透析的成年人参加了定量阶段。定性阶段包括48名从定量样本中选择的中度至重度瘙痒的参与者，定义为五维瘙痒量表得分为12或更高。测量：数据收集于2025年10月至2026年1月。使用五维瘙痒量表和为本研究开发的社会人口学和临床信息表收集定量数据。定性数据是通过对每位参与者至少两次半结构化访谈产生的，并使用反身性主题分析进行分析。集成在解释阶段进行。结果：五维瘙痒量表平均评分为8.00±3.21分，中重度瘙痒患病率为16.3%。多变量分析显示，已婚参与者的症状报告较低，而合并症和既往瘙痒相关教育与较高的症状报告相关。定性研究结果表明，瘙痒是一种影响睡眠、日常舒适和社会角色的波动负担。参与者描述了反复试验的自我管理策略，并表达了积极评估、实际指导和个性化护理的必要性。结论：慢性肾脏疾病相关性瘙痒在血液透析护理中仍然是一个多方面的负担。标准化的评估和以人为本的护理可以提高对其的认识和管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of renal care Nursing-Advanced and Specialized Nursing

CiteScore

3.50

自引率

5.30%

发文量

期刊介绍： The Journal of Renal Care (JORC), formally EDTNA/ERCA Journal, is the official publication of the European Dialysis and Transplant Nursing Association/European Renal Care Association (EDTNA/ERCA). The Journal of Renal Care is an international peer-reviewed journal for the multi-professional health care team caring for people with kidney disease and those who research this specialised area of health care. Kidney disease is a chronic illness with four basic treatments: haemodialysis, peritoneal dialysis conservative management and transplantation, which includes emptive transplantation, living donor & cadavaric transplantation. The continuous world-wide increase of people with chronic kidney disease (CKD) means that research and shared knowledge into the causes and treatment is vital to delay the progression of CKD and to improve treatments and the care given. The Journal of Renal Care is an important journal for all health-care professionals working in this and associated conditions, such as diabetes and cardio-vascular disease amongst others. It covers the trajectory of the disease from the first diagnosis to palliative care and includes acute renal injury. The Journal of Renal Care accepts that kidney disease affects not only the patients but also their families and significant others and provides a forum for both the psycho-social and physiological aspects of the disease.