Determinants of uremic pruritus severity among patients undergoing chronic hemodialysis: A cross-sectional study

Uremic pruritus, also called chronic kidney disease-associated Pruritus (CKD-aP), is a symptom of severe and ongoing itching that patients with CKD or end-stage renal disease frequently experience. The purpose of this study was to evaluate the factors associated with moderate-to-severe uremic pruritus in patients receiving chronic hemodialysis. This cross-sectional study was conducted at Dr Sulaiman Al-Habib Hospital in Riyadh, Saudi Arabia, from June to October 2025. The severity of itching was assessed using a single-item scale from 0 to 10, with 0 indicating no itching and 10 indicating maximum itching. Responses of >0 were summed to obtain itching intensity. Among participants, 53 (57.0%) were male. The prevalence of severe itching among participants was 10.8%, with a mean itching scale score of 2.35 ± 2.85 out of 10. The noncitizen participants showed higher itching scores than Saudi patients, with a difference that reached the threshold of statistical significance (4.00 ± 3.43) and (2.18 ± 2.75), respectively. Multivariable logistic regression identified that females were 4 times more likely to have moderate-to-severe itching than males (aOR: 5.64 [95% CI: 1.39-22.99]). The majority of hemodialysis patients had minor uremic pruritus. Further research involving larger samples is also warranted to investigate the factors contributing to uremic pruritus in hemodialysis patients.