IMPACT OF PRURITUS ON QUALITY OF LIFE IN HEMODIALYSIS PATIENTS

Background: Chronic Kidney Disease-associated pruritus (CKD-aP) is a common complication among hemodialysis patients and significantly affects quality of life. Pruritus may lead to sleep disturbance, psychological stress, reduced daily functioning, and increased morbidity and mortality. Despite its prevalence, the condition is frequently underreported and inadequately managed. Various factors, including inflammation, xerosis, metabolic imbalance, and neuropathy, contribute to the development of CKD-aP (1–3). Therefore, this study was conducted to assess the severity of pruritus, evaluate its impact on quality of life, and determine patients’ awareness regarding pruritus among hemodialysis patients. Objectives: to assess the severity of pruritus, evaluate its impact on quality of life, and determine patients’ awareness regarding pruritus among hemodialysis patients. Methodology: A descriptive cross-sectional study was conducted among 132 hemodialysis patients at the dialysis unit of Lady Reading Hospital over a 4–6-month period. Adult patients undergoing maintenance hemodialysis for at least three months were included. Data were collected using a structured questionnaire comprising demographic characteristics, the 5-D Itch Scale for pruritus severity assessment, the Dermatology Life Quality Index (DLQI) for quality of life evaluation, and questions assessing awareness regarding pruritus. Informed consent was obtained from all participants before data collection. Results: Among 132 hemodialysis patients, 61.4% were male and 38.6% were female. Most patients (78.0%) underwent dialysis twice weekly. Mild pruritus was reported by 47.0% of patients, moderate pruritus by 29.5%, severe pruritus by 18.2%, and unbearable pruritus by 2.3%. More than half of patients (55.3%) experienced daily itching for less than 6 hours. Pruritus significantly affected quality of life, particularly sleep, work, housework, and social activities. Moderate sleep disturbance was reported by 41.7% of participants, while 23.5% experienced severe sleep impairment. The back (36.4%) and legs (28.8%) were the most commonly affected body areas. DLQI scores showed the greatest impact on housework activities and sleep. Awareness regarding pruritus was generally poor, as 59.1% of participants had never heard about pruritus, and only 24.2% knew that CKD could cause itching. Most patients (66.7%) believed that pruritus is treatable. Overall, pruritus had a substantial negative impact on the quality of life of hemodialysis patients and highlighted the need for improved patient education and symptom management. Conclusion: Pruritus is highly prevalent among hemodialysis patients and significantly impairs quality of life, particularly sleep, daily activities, and social functioning. Patient awareness regarding CKD-associated pruritus was found to be limited. Routine screening, patient education, and effective management strategies are essential to reduce symptom burden and improve the overall well-being of hemodialysis patients.