Prevalence and burden of chronic kidney disease-associated pruritus in Europe (CENSUS-EU)

Background: Chronic kidney disease-associated pruritus (CKD-aP) is associated with poor health-related quality of life (HRQoL). However, clarity on its prevalence is lacking. CENSUS-EU was a real-world, cross-sectional, non-interventional, multicentre study carried out in seven European countries to assess the prevalence of CKD-aP and its impact on HRQoL in patients receiving haemodialysis (HD). Methods: Patients aged ≥18 years with CKD who were receiving in-centre HD for ≥3 months were eligible for enrolment. Medical records were used to gather baseline demographics and clinical characteristics. Patients completed patient-reported outcomes on pruritus severity (the Worst Itching Intensity Numerical Rating Scale) and HRQoL. They also completed a questionnaire on pruritus communication and treatment. Data were analysed by pruritus severity. Results: Of 3095 enrolled patients, data concerning 2963 were available for analysis. Mean age was 66.2 years, and 62.7% were male. The prevalence of CKD-aP was 53.5%; 22.3% of patients experienced mild, 18.0% moderate, and 13.2% severe pruritus. Patients with moderate-to-severe pruritus experienced greater difficulty sleeping, higher depression scores, greater disability, and impact on daily activities compared with patients with no pruritus (P < .0001, all comparisons). Patients mainly reported pruritus to nephrologists (49%) or dialysis nurses (33.8%). However, 26.2% of patients experiencing pruritus did not report it to anyone, and 40.9% of patients with current or past severe itch were untreated at the time of study visit. Conclusions: In this study, over half of patients experienced CKD-aP, with 31.2% reporting moderate or severe symptoms. Many patients were untreated despite experiencing itch that impacted their HRQoL and day-to-day activities. Clinical Trial Registration This study was registered at ClinicalTrials.gov (Identifier: NCT05524467).