Epidemiological characteristics and factors associated with chronic kidney disease-associated pruritus in the Chinese adult dialysis population: a multicenter, cross-sectional study

To our knowledge, no large‑sample epidemiological studies on chronic kidney disease‑associated pruritus (CKD‑aP) have been reported in China in recent years. We aimed to investigate the prevalence and related factors of CKD-aP in Chinese dialysis population. This study included data on 9,589 dialysis patients across 30 provincial-level administrative divisions in mainland China between May 2022 and December 2022. The EQ-5D was used to collect patient information. Pruritus severity was assessed using the Numerical Rating Scale (NRS). Generalized estimating equations (GEE) were used to explore the potential influencing factors of CKD-aP. The prevalence of CKD-aP in Chinese adult dialysis patients was 60.3%. The prevalence of mild, moderate, and severe pruritus was 44.4%, 12.5%, and 3.3%, respectively. The prevalence of pruritus, moderate-to-severe pruritus, and severe pruritus in hemodialysis (HD) patients was 59.9%, 16.0%, and 3.4%, respectively. The prevalence of pruritus, moderate-to-severe pruritus, and severe pruritus in peritoneal dialysis (PD) patients was 61.8%, 14.1%, and 2.8%, respectively. No significant difference in pruritus prevalence was observed between HD (59.9%) and PD (61.8%) patients. Only 2.9% of the patients received potentially effective treatment (gabapentinoids 2.8%, kappa opioid receptor agonists 0.1%). Smoking history, diabetic nephropathy, cardiovascular diseases, dialysis vintage, eosinophil count, serum total calcium, and serum phosphorus were factors associated with CKD-aP. CKD-aP is highly prevalent among Chinese dialysis patients, with comparable rates between HD and PD populations. Several modifiable and non-modifiable factors were significantly associated with pruritus. Few patients received potentially effective treatment. These results highlight the potential targets for improving patient management.