OBJECTIVES: Chronic kidney disease–associated pruritus (CKD-aP) is a common, yet underdiagnosed condition among patients on hemodialysis. We assessed healthcare resource utilization (HRU) associated with CKD-aP intensity in a large, multinational sample of hemodialysis patients.

METHODS: Nephrocare launched a country-wide quality of life improvement program, ePROM-QI, in France, Italy, Spain, United Kingdom and Ireland. ePROM-QI aimed at addressing health-related quality of life issues among hemodialysis patients. Patients were invited to respond to a survey through a Patient Reported Outcome Measure (ePROM) administration platform embedded in the Health Information System, EuCliD®. In this historical cohort study, we included all patients participating in ePROM-QI who consented their data be used for retrospective research. CKD-aP severity was documented by the Kidney Disease Quality of Life-36 (KDQOL™-36) and the 5-D Itch questionnaires. We captured HRU in the 12 months following the date of survey administration. Potential confounders were ascertained in the 12 months prior to index date. We assessed the association between CKD-aP severity and HRU with mixed-effect generalized linear models accounting for potential confounders.

RESULTS: We included 6,262 patients of whom roughly 50% reported some degree of CKD-aP. Patients with severe CKD-aP more likely received off-label systemic pruritus medications (i.e. gabapentin and pregabalin) and antidepressants. Severe CKD-aP was associated with higher likelihood of missing dialysis sessions in the course of the follow-up year. We found no statistically significant difference in hospitalization rates across CKD-aP severity classes.

CONCLUSIONS: CKD-aP was common among dialysis patients in five European countries. Specifically for utilization of topical and systemic anti-pruritus medications and utilization of antidepressants, there appeared to be a consistent trend between the increase of pruritus intensity and HRU. These findings may suggest that CKD-aP has a specific physical and emotional burden for patients suffering from pruritus.