Abstract: SA-PO289
Insights Into Current Practices and Unmet Needs Relating to CKD-Associated Pruritus: Results From a Canadian Nephrologist Survey
Session Information
- Hemodialysis and Frequent Dialysis: Potpourri
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Schwartz, Daniel, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
- Miciak, Gerald, Otsuka Canada Pharmaceutical Inc., Saint-Laurent, Quebec, Canada
- Magnaye, Arthur, Otsuka Canada Pharmaceutical Inc., Saint-Laurent, Quebec, Canada
Background
Chronic kidney disease-associated pruritus (CKD-aP) is a common condition in patients with CKD undergoing hemodialysis (HD). In this real-world study, Canadian nephrologists were surveyed to gain insight into current practices and unmet needs related to the treatment of CKD-aP.
Methods
Quantitative data regarding the perception of current treatment practices for CKD-aP were collected in November and December 2021 by a 20-minute survey completed by 62 nephrologists across Canada. Respondents’ level of agreement was assessed using a 7-point scale.
Results
In current practice, the mean perceived prevalence of CKD-aP in HD patients was 30.5%. Of these, 33.6% and 18.3%, respectively, experience moderate or severe CKD-aP. CKD-aP was most frequently identified (75.8% of cases) through patients complaining of itch to the multidisciplinary health care team. In clinical practice 63% of respondents currently do not use formal scales to diagnose and assess CKD-aP. Treatments used for severe and moderate CKD-aP are shown in the table. Nephrologists used topical moisturizers / emollients (85%), oral antihistamines (14%), and gabapentinoids (2%) as first-line treatments. Nephrologists reported 42% of patients with severe CKD-aP and 41% with moderate CKD-aP do not respond to treatment. Most nephrologists (94%) agreed there is a need for new treatments specifically designed to address CKD-aP, 68% agreed they do not expect to resolve a patient's CKD-aP with currently available treatments, 89% agreed CKD-aP is challenging to treat, and 69% agreed there is a need for guidelines for the treatment of CKD-aP.
Conclusion
This real-world Canadian study of nephrologists showed that CKD-aP is challenging to treat and many patients do not respond to currently-available treatments. There is an urgent unmet need for new, more effective treatments and for guidelines to aid nephrologists in selecting therapy for their patients with CKD-aP.
Treatment Choices
| Treatment | Reported use in severe CKD-aP (%) | Reported use in moderate CKD-aP (%) |
| Topical moisturizers / emollients | 78 | 69 |
| Oral antihistamines | 58 | 37 |
| Gabapentinoids | 51 | 31 |
| Topical corticosteroids | 35 | 20 |
| UVB therapy | 22 | 8 |
| Antidepressants / anxiolytics / sedatives | 14 | 5 |
Funding
- Commercial Support – Otsuka