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Health-related quality of life in haemodialysis patients suffering from chronic itch: results from GEHIS (German Epidemiology Haemodialysis Itch Study)

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Abstract

Purpose

Chronic itch (CI) is a common symptom in haemodialysis (HD) patients affecting about every 4th HD patient. Though it is known that health-related quality of life (HRQOL) is impaired in HD patients, data are lacking on how CI influences HRQOL in this group of patients, also regarding sex differences and the role of sleep and pain.

Methods

In order to investigate the itch prevalence and to investigate associated factors, GEHIS (German Epidemiology Haemodialysis Itch Study) was established as first cross-sectional study being representative for all dialysis units in Germany by considering their regional distribution and size of the located city according to population. HRQOL of 860 HD patients from a randomly selected cluster sample of 25 dialysis units was investigated using patient-reported outcomes as the Short-Form Health Survey (SF-12), the Hospital Anxiety and Depression Scale (HADS) as well as sleep and pain. Additionally, itch-specific QOL was assessed in HD patients affected by CI using the validated ItchyQoL.

Results

42.8 % of HD patients were female. The mean age was 67.2 years (SD ± 13.5). Female patients showed significantly worse values in the mental component summary of the SF-12 as well as in the HADS subscale anxiety compared to male patients. Itch-specific HRQOL did not subject to sex. Patients with impairments in quality of sleep showed significantly worse values in both the SF-12 and the HADS subscales, however not in the ItchyQoL. The occurrence of pain was significantly associated with impaired SF-12, HADS and the ItchyQoL. Multivariate linear regression showed the itch-specific HRQOL to be significantly impaired with rising severity of CI.

Conclusions

Impairments in HRQOL are a serious problem in HD patients. CI means an additional burden in affected patients, also impairing their HRQOL. GEHIS showed significant sex differences in HRQOL outcomes also in HD patients. CI and pain as well as sleep frequently occur combined and significantly impair HRQOL in HD patients. The care of HD patients should be complemented by psychosocial support and mental health services.

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Acknowledgments

We thank all the participating dialysis units and especially all HD patients for participating in this study. We thank Kinan Hayani for his help in obtaining and entering the data.

Funding

GEHIS was financially supported by Fresenius Medical Care Germany GmbH (no grant number). The sponsor had no role in design and conduct of the study, in the collection, analysis and interpretation of data or in the approval of this article.

Author information

Authors and Affiliations

  1. Department of Clinical Social Medicine, Occupational and Environmental Dermatology, Ruprecht-Karls University Heidelberg, Thibautstrasse 3, 69115, Heidelberg, Germany

    Melanie Weiss & Elke Weisshaar

  2. Department of Nephrology, DKD Helios Clinic, Wiesbaden, Germany

    Thomas Mettang

  3. Fresenius Medical Care Deutschland GmbH, Bad Homburg, Germany

    Ulrich Tschulena

Authors
  1. Melanie Weiss
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  2. Thomas Mettang
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Corresponding author

Correspondence to Melanie Weiss.

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Conflict of interest

Thomas Mettang, nephrologist, serves as an advisor for Fresenius Medical Care Germany GmbH and received payments for consultations and lectures from Fresenius Medical Care Germany GmbH. The sponsor, represented by Ulrich Tschulena had no influence on the design, conduct, collection and interpretation of data of the study. Melanie Weiss and Elke Weisshaar declare no conflict of interest. There were no personal involvements that pose a potential duality of interest by conducting the study and analyzing its data.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was obtained from all individual participants included in the study.

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Weiss, M., Mettang, T., Tschulena, U. et al. Health-related quality of life in haemodialysis patients suffering from chronic itch: results from GEHIS (German Epidemiology Haemodialysis Itch Study). Qual Life Res 25, 3097–3106 (2016). https://doi.org/10.1007/s11136-016-1340-4

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  • DOI: https://doi.org/10.1007/s11136-016-1340-4

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