慢性肾病患者瘙痒症早期诊断和治疗的障碍:目前的观点。

Chandra Mauli Jha, Hormaz Dara Dastoor, Natrajan Gopalakrishnan, Stephen Geoffrey Holt
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引用次数: 0

摘要

慢性肾脏疾病相关性瘙痒(CKD- ap)是晚期慢性肾脏疾病(CKD)患者的常见疾病。几项研究已经证实,超过四成的早期CKD患者患有这种疾病,而在透析的CKD患者中,其患病率高达七成。注意到它与其他致残症状和严重后果有关。它对CKD患者的睡眠、情绪、日常活动和生活质量有显著影响,并增加血液透析患者的死亡风险。透析结果和实践模式研究发现,中度至重度瘙痒患者的死亡率比无或轻度瘙痒患者高17%。尽管CKD-aP的患病率高,不良影响和痛苦,但令人惊讶的是,CKD-aP在患者方面的报道和医疗团队的认识都不足。即使被注意到,它仍然无人看管,待遇也很差。其发病机制复杂,尚不完全清楚。有许多治疗方案可供选择,但其中大多数缺乏高质量的证据,迄今为止,只有两种药物被批准用于这种情况。虽然非常需要一个有效的指导方针,以使患者和护理人员受益,但需要对这个问题的几个方面进行进一步的研究。
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Obstacles to Early Diagnosis and Treatment of Pruritus in Patients with Chronic Kidney Disease: Current Perspectives.

Chronic kidney disease-associated pruritus (CKD-aP) is a common condition amongst patients with advanced chronic kidney disease (CKD). Several studies have confirmed that more than four out of ten early-stage CKD patients suffer from this condition, while its prevalence among CKD patients on dialysis reaches up to seven out of ten. It is noted to be associated with other disabling symptoms and serious outcomes. It has significant impact on sleep, mood, daily activities, and quality of life of CKD patients, and increased mortality risk of patients on hemodialysis. The Dialysis Outcomes and Practice Patterns Study found 17% higher mortality among patients with moderate to extreme pruritus compared with patients with no or mild pruritus. Despite its high prevalence, ill-effect, and suffering associated with it, CKD-aP remains surprisingly under-reported on the patient's part and under-recognized by the healthcare team. Even upon being noticed, it remains unattended and poorly treated. Its etiopathogenesis is complex and not fully understood. Many treatment options are available but good quality evidence about most of those is absent, and to date, only two medications are approved for use in this condition. While a validated guideline is very much required for the benefit of the patients and caretakers, further research on several aspects of this issue is required.

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来源期刊
CiteScore
3.90
自引率
5.00%
发文量
40
审稿时长
16 weeks
期刊介绍: International Journal of Nephrology and Renovascular Disease is an international, peer-reviewed, open-access journal focusing on the pathophysiology of the kidney and vascular supply. Epidemiology, screening, diagnosis, and treatment interventions are covered as well as basic science, biochemical and immunological studies. In particular, emphasis will be given to: -Chronic kidney disease- Complications of renovascular disease- Imaging techniques- Renal hypertension- Renal cancer- Treatment including pharmacological and transplantation- Dialysis and treatment of complications of dialysis and renal disease- Quality of Life- Patient satisfaction and preference- Health economic evaluations. The journal welcomes submitted papers covering original research, basic science, clinical studies, reviews & evaluations, guidelines, expert opinion and commentary, case reports and extended reports. The main focus of the journal will be to publish research and clinical results in humans but preclinical, animal and in vitro studies will be published where they shed light on disease processes and potential new therapies and interventions.
期刊最新文献
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