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CKD-aP Among Adults on Dialysis in Switzerland

Completed
Conditions
Chronic Kidney Diseases Associated Pruritus
Dialysis
Chronic Kidney Diseases
Registration Number
NCT05415969
Lead Sponsor
University of Applied Sciences of Western Switzerland
Brief Summary

Chronic Kidney Disease Associated Pruritus (CKD-aP) represents a localized or a generalized skin itch, which is a common symptom occurring in end-stage renal disease and dialysis. The prevalence of CKD-aP in adults on dialysis varies between countries ranging between 20-42%. Swiss data on CKD-aP are unfortunately largely lacking, as Switzerland is so far not part of large registries, such as DOPPS.

The aging population, the increase in diabetes (69% by 2030), the increase in hypertension (60% by 2025) and poly-morbidity will probably lead to a rise in the number of patients on dialysis and subsequent CKD-aP.

CKD-aP is associated with sleep disturbances, compromised quality of life, emotional distress, and increased risks of hospitalization and death. Its management lacks approaches that are supported by strong evidence because its pathogenesis remains poorly understood and may be related to an increase in uremic toxins, skin inflammation. In this context, sweat composition deserves more attention.

Aim of the study The aim of the study is to determine the prevalence of CKD-aP in the population on dialysis, the association between CKD-aP and different electrolytes, and the potential role of the composition of sweat in CKD-aP.

Results will be used for building a CKD-aP symptom management program to improve the quality of care of patients on dialysis and will be incorporated in the nursing continuing education program.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
401
Inclusion Criteria
  • Adult ≥ 18 years old
  • Diagnosed with end-stage renal disease and receiving hemodialysis for at least 6 months
  • Able to communicate in French or availability of a French-speaking close relative for translation
  • Signed informed consent

Additional inclusion criteria for the case-control study outcomes phase 2:

  • Reporting moderate to severe CKD-aP for the participant considered as a case
  • Reporting no or mild CKD-aP for the participant considered as a control Cases and controls will be matched by age-group, sex, and dialysis modality (hemodialysis or peritoneal dialysis).
Exclusion Criteria
  • Presence of cognitive impairment or cognitive disorder

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Prevalence of CKD-aPJune 27, 2022- October 31, 2023

Evaluation of the presence of CKD-aP. This outcome prevalence will be reported in %.

Severity of CKD-aP using the Visual Analog ScaleJune 27, 2022- October 31, 2023

Severity of CKD-aP will be measured using the Visual Analog Scale (VAS) questionnaire. Participants will be asked to rate their maximum pruritus intensity during the last 24 hours.

The VAS score ranges from 0 (not itchy) to 10 (extremely itchy); Severity will be classified into five categories: 1) 0 = no pruritus, 2) 0.1-2.9 points = mild pruritus, 3) 3.0-6.9 points = moderate pruritus, 4) 7.0-8.9 points = severe pruritus, and 5) 9.0-10.0 points = very severe pruritus. Higher scores indicate a worse outcome.

Severity of CKD-aP using the Verbal Rating ScaleJune 27, 2022- October 31, 2023

Severity of CKD-aP will also be measured using the Verbal Rating Scale (VRS) questionnaire. Participants will be asked to rate their maximum pruritus intensity during the last 24 hours.

The VRS is a five-point scale and consists of a list of adjectives describing various levels of symptom intensity (0= no itch, 1= mild itch, 2= moderate itch, 3= severe itch and 4=very severe itch). Higher scores indicate a worse outcome.

Secondary Outcome Measures
NameTimeMethod
Calcium level (mg/l) in sweatJune 27, 2022- October 31, 2023

Measurement of calcium (mg/l) in a subgroup of patients with CKD-aP and their age-sex-matched controls on dialysis.

60 participants (30 cases and 30 controls)

Sodium level (mmol/l) in sweatJune 27, 2022- October 31, 2023

Measurement of sodium (mmol/l) in a subgroup of patients with CKD-aP and their age-sex-matched controls on dialysis.

60 participants (30 cases and 30 controls)

Urea level (mmol/l) in sweatJune 27, 2022- October 31, 2023

Measurement of urea (mmol/l) in a subgroup of patients with CKD-aP and their age-sex-matched controls on dialysis.

60 participants (30 cases and 30 controls)

Potassium level (mmol/l) in sweatJune 27, 2022- October 31, 2023

Measurement of potassium (mmol/l) in a subgroup of patients with CKD-aP and their age-sex-matched controls on dialysis.

60 participants (30 cases and 30 controls)

Phosphorus level (mg/ml) in sweatJune 27, 2022- October 31, 2023

Measurement of phosphorus (mg/ml) in a subgroup of patients with CKD-aP and their age-sex-matched controls on dialysis.

60 participants (30 cases and 30 controls)

Chloride level (mmol/l) in sweatJune 27, 2022- October 31, 2023

Measurement of chloride (mmol/l) in a subgroup of patients with CKD-aP and their age-sex-matched controls on dialysis.

60 participants (30 cases and 30 controls)

Trial Locations

Locations (1)

University of Lausanne Hospitals

🇨🇭

Lausanne, Vaud, Switzerland

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