Abstract: SA-PO1103
CKD-Associated Pruritus (CKD-aP): Associations with Cardiovascular and Infection Events in Non-Dialysis CKD Patients
Session Information
- CKD Epidemiology, Risk Factors, Prevention - III
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Scherer, Jennifer S., New York University Grossman School of Medicine, New York, New York, United States
- Tu, Charlotte, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
- Pisoni, Ronald L., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
- Speyer, Elodie, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France
- Lopes, Antonio Alberto, Universidade Federal da Bahia, Salvador, Brazil
- Wen, Warren, Cara Therapeutics Inc, Stamford, Connecticut, United States
- Menzaghi, Frederique, Cara Therapeutics Inc, Stamford, Connecticut, United States
- Cirulli, Josh, Cara Therapeutics Inc, Stamford, Connecticut, United States
- Alencar de Pinho, Natalia, Centre de Recherche en Epidemiologie et Sante des Populations, Villejuif, Île-de-France, France
- Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
- Karaboyas, Angelo, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
Background
Chronic kidney disease associated pruritus (CKD-aP) is a disturbing symptom of CKD. We describe the prevalence of CKD-aP in non-dialysis CKD, treatment patterns, and associations with clinical outcomes.
Methods
We analyzed 4410 patients from 91 clinics in Brazil, France, and US enrolled in the CKDopps (2013-2021), a prospective cohort of adults not on dialysis with an eGFR <60 mL/min/1.73m2. CKD-aP was self-reported by response to the question: During the past 4 weeks, to what extent were you bothered by itchy skin? Associations with time-to-event outcomes were investigated using Cox regression models adjusted for potential confounders.
Results
The proportion of patients not at all, somewhat, moderately, very much, and extremely bothered by itchy skin was 49%, 27%, 13%, 7%, and 3%, respectively. Among patients at least moderately bothered, 23% were prescribed at least one pharmacotherapy – 35% in the US, 19% in France, 4% in Brazil – including antihistamine (10%), gabapentin (6%), topical corticosteroids (4%), pregabalin (3%), or sedating antihistamine (3%). The hazard ratio (95% CI) for patients extremely (vs. not at all) bothered was 1.84 (1.22, 2.75) for cardiovascular events and 1.36 (0.80, 2.31) for infection events.
Conclusion
CKD-aP can cause significant discomfort for individuals, however we found less than a quarter impacted in our cohort received treatment, and medications chosen can have significant side effects. We also found an increased risk of adverse clinical events with worsening CKD-aP. These results highlight the need for further investigation and education about CKD-aP.
Funding
- Commercial Support – This manuscript was directly supported by Cara Therapeutics. Global support for the ongoing DOPPS Programs is provided without restriction on publications by a variety of funders. For details see https://www.dopps.org/AboutUs/Support.aspx. As of May 5, 2023, the DOPPS program is supported by Amgen Inc. (since 1996, founding sponsor); Akebia Therapeutics, Inc.; Astellas Pharma Inc.; Bard Peripheral Vascular, Inc.; Baxter Healthcare Corp; Bayer AG & Bayer Yakuhin, Ltd; Cara Therapeutics, Inc.; Chugai Pharmaceutical Co., LTD; GlaxoSmithKline LLC; Japanese Society for Peritoneal Dialysis; JMS Co., Ltd; Kidney Foundation Japan; Kissei Pharmaceutical Co., Ltd; Kyowa Kirin Co., Ltd. (since 1999 for Japan DOPPS); Merck Sharp & Dohme Corp; Nikkiso Co., Ltd.; ONO Pharmaceutical Co., Ltd; Terumo Corporation; Torii Pharmaceutical Co., Ltd; CSL-Vifor, Ltd.