OBJECTIVES: Chronic kidney disease-associated pruritus (CKD-aP) is common with hemodialysis, yet little is known regarding patients’ perspectives of itch. This study aimed to assess patient-reported itch among individuals with CKD/ESKD receiving hemodialysis.

METHODS: Eligible participants of Kantar Profiles general panel or American Association of Kidney Patients patient-advocacy group were aged ≥18 years old, resided in the USA, self-reported physician diagnosis of CKD/ESKD, received hemodialysis 3 times-per-week, gave informed consent, and reported any itch in the past 28 days. Participants were stratified using worst itch numerical rating scale (WI-NRS) into mild (1–3), moderate (4–6), and severe (7–10) groups. Descriptive statistics were used to assess participant demographics, itch and CKD/ESKD clinical characteristics, validated itch assessments, itch burden, work productivity and activity impairment (WPAI: 0–100 scale [higher=greater impairment/less productivity]), sleep quality questionnaire (SQQ: 0–10 scale [10=itch completely interfered with sleep in the past 24 hours]), provider interactions, and itch treatments.

RESULTS: Survey fielding occurred 12/1/2021–5/31/2022, generating 354 observations. Stratification by WI-NRS yielded 76, 173, and 105 participants classified as mild, moderate, and severe, respectively. Overall mean age 45.8 years, 52% female, and mean time since CKD/ESKD-diagnoses and time on hemodialysis were 14.4 and 4.4 years, respectively. A relationship was found between worse WI-NRS-based itch severity and poorer patient outcomes. Proportions self-reporting extremely-high/high burden of itch was 5.3%, 20.8%, and 54.3% among mild, moderate, and severe WI-NRS groups, respectively. Similarly, poorer sleep by SQQ (mild=2.6, moderate=4.7, severe=7.0), and overall activity impairment (mild=21.5, moderate=39.8, severe=67.0), absenteeism (mild=12.7, moderate=16.0, severe=31.9), presenteeism (mild=23.5, moderate=45.9, severe=63.8) and overall work impairment (mild=18.6, moderate=37.7, severe=42.5) by WPAI were seen with worse WI-NRS-based itch severity.

CONCLUSIONS: CKD-aP among participants undergoing hemodialysis displays a relationship between worse itch severity and greater burden on patients. Further evidence is needed to better quantify patients’ burden from chronic itch.