Development of Substance Use Disorder in Chronic Kidney Disease Patients Experiencing Uremic Pruritus
Author(s)
Garate D1, Thomas D2, Flores I3, Morgan B2, Fu S4, Golovko G5
1University of Texas Medical Branch John Sealy School of Medicine, Texas City, TX, USA, 2University of Texas Medical Branch John Sealy School of Medicine, Galveston, TX, USA, 3Sam Houston State University College of Osteopathic Medicine, Conroe, TX, USA, 4Baylor College of Medicine, Houston, TX, USA, 5University of Texas Medical Branch, Galveston, TX, USA
Presentation Documents
OBJECTIVES:
Uremic Pruritus (UP) is a distressing symptom that occurs in nearly half of patients with end-stage renal disease (ESRD), involving near-daily itching across large and bilaterally symmetrical skin regions. UP is associated with diminished quality of life and mental health burden. This study aims to assess the development of substance use disorders (SUD) in patients with ESRD who experience uremic pruritus.METHODS:
TriNetX, a federated health research network database was utilized to conduct a retrospective cohort study. Using validated ICD-10 codes, the population was stratified to compare ESRD/CKD stage 5 patients with and without a subsequent diagnosis of UP. After propensity-matching for demographics and related comorbidities, we analyzed the incidence of subsequent SUD at 30 days, 90 days, 1 year, and 5 years thereafter using adjusted Risk Ratios (aRR) with 95% CI.RESULTS:
Increased risk for alcohol abuse or dependence was observed at 30 days (aRR [95% CI])=(1.78[1.51,2.10]), 90 days(1.92[1.68, 2.20]), 1 year (2.26[2.05, 2.49]), and 5 years (1.99[1.84, 2.15]). Opioid abuse or dependence demonstrated greater risk at 30 days (1.53, 3.18), 90 days(2.01[1.55, 2.61]), 1 year (1.83[1.54, 2.17]), and 5 years (1.66[1.47, 1.88]). Increased risk for cannabis abuse or dependence was significant at 30 days (1.94[1.28, 2.93]), 90 days(1.65[1.23, 2.22]), 1 year (1.59[1.30, 1.94]), and 5 years (1.41[1.20, 1.63]). Greater risk for Sedative-hypnotic-anxiolytic abuse or dependence was observed at 30 days (2.26[1.44, 4.92]), 90 days(2.33[1.50, 3.59]), 1 year (2.43[1.80, 3.29]), and 5 years (1.96[1.58, 2.44]). Increased risk for nicotine dependence was observed at 90 days(1.18[1.07, 1.30]), 1 year (1.45[1.35, 1.55]), and 5 years (1.29[1.22, 1.35]).CONCLUSIONS:
The results demonstrate increased risk over most time periods for the development of SUD regarding opioids, nicotine, cannabis, and alcohol in ESRD patients afflicted with UP and highlight the need for personalized assessment of patient psychiatric care needs and resources if subjected to this distressing symptom.Conference/Value in Health Info
2023-05, ISPOR 2023, Boston, MA, USA
Value in Health, Volume 26, Issue 6, S2 (June 2023)
Code
EPH249
Topic
Real World Data & Information Systems
Topic Subcategory
Distributed Data & Research Networks, Reproducibility & Replicability
Disease
Mental Health (including addition), Sensory System Disorders (Ear, Eye, Dental, Skin), Urinary/Kidney Disorders