{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T02:45:42Z","timestamp":1790649942393,"version":"4.1.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2017,12]]},"abstract":"\n Background and objectives<\/jats:title>\n Uremic pruritus in patients on hemodialysis is associated with depression, lower quality of life, and mortality. We studied the prevalence, awareness, and treatment of pruritus to assess how well this important condition is currently managed internationally.<\/jats:p>\n <\/jats:sec>\n \n Design, setting, participants, & measurements<\/jats:title>\n Data from 35,452 patients on hemodialysis in up to 17 countries from the Dialysis Outcomes and Practice Patterns Study were analyzed to describe pruritus prevalence from 1996 to 2015. Data from 6256 patients and 268 medical directors in 17 countries in 2012\u20132015 were analyzed to describe predictors, effects, medical directors\u2019 awareness, and treatment of pruritus.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Patients very much or extremely bothered by itching declined from 28% in 1996 to 18% in 2015. In 2012\u20132015, among patients nearly always or always bothered by itching, pruritus had a major effect on work and social life; 18% used no treatment for pruritus, and 17% did not report itching to health care staff. In total, 69% of medical directors underestimated the prevalence of pruritus in their unit. Managing high serum phosphorus and low Kt\/V was ranked as the most important intervention, but no relationship was found between these factors and pruritus; 57% of medical directors used oral antihistamines for first-line chronic treatment of pruritus. Gabapentin was used by 45% as first-, second-, or third-line treatment. Nalfurafine was only used in Japan.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The prevalence of pruritus in people on hemodialysis is decreasing but remains underestimated. Large numbers of patients on hemodialysis with severe pruritus do not receive treatment. There is wide variation in the use of unlicensed medications for the treatment of pruritus. These data provide a benchmark for initiatives to improve the management of uremic pruritus.<\/jats:p>\n <\/jats:sec>\n \n Multimedia<\/jats:title>\n This article contains multimedia at https:\/\/vimeo.com\/49458473<\/jats:p>\n This article contains multimedia at vimeo.com\/49455976<\/jats:p>\n <\/jats:sec>","DOI":"10.2215\/cjn.03280317","type":"journal-article","created":{"date-parts":[[2017,9,18]],"date-time":"2017-09-18T21:00:26Z","timestamp":1505768426000},"page":"2000-2007","source":"Crossref","is-referenced-by-count":272,"title":["International Comparisons of Prevalence, Awareness, and Treatment of Pruritus in People on Hemodialysis"],"prefix":"10.2215","volume":"12","author":[{"given":"Hugh C.","family":"Rayner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Larkina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mia","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Graham-Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine N.","family":"van der Veer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tevfik","family":"Ecder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Hasegawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Kleophas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian A.","family":"Bieber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Tentori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce M.","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald L.","family":"Pisoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,9,18]]},"reference":[{"key":"B1-20230813","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.2215\/CJN.00430109","article-title":"Symptom burden, depression, and quality of life in chronic and end-stage kidney disease.","volume":"4","author":"Abdel-Kader","year":"2009","journal-title":"Clin J Am Soc Nephrol"},{"key":"B2-20230813","doi-asserted-by":"crossref","first-page":"3495","DOI":"10.1093\/ndt\/gfl461","article-title":"Pruritus in haemodialysis patients: International results from the Dialysis Outcomes and Practice Patterns Study (DOPPS).","volume":"21","author":"Pisoni","year":"2006","journal-title":"Nephrol Dial Transplant"},{"key":"B3-20230813","doi-asserted-by":"crossref","first-page":"960","DOI":"10.2215\/CJN.00990207","article-title":"Renal provider recognition of symptoms in patients on maintenance hemodialysis.","volume":"2","author":"Weisbord","year":"2007","journal-title":"Clin J Am Soc Nephrol"},{"key":"B4-20230813","doi-asserted-by":"crossref","first-page":"1528","DOI":"10.1089\/jpm.2013.0176","article-title":"Improving symptom management in hemodialysis patients: Identifying barriers and future directions.","volume":"16","author":"Feldman","year":"2013","journal-title":"J Palliat Med"},{"key":"B5-20230813","doi-asserted-by":"crossref","first-page":"1328","DOI":"10.1093\/ndt\/gfn769","article-title":"How do nephrologists in haemodialysis units consider the symptom of itch? 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The role of plasma histamine and skin mast cells.","volume":"34","author":"Mettang","year":"1990","journal-title":"Clin Nephrol"},{"key":"B34-20230813","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1038\/ki.2013.454","article-title":"Uremic pruritus.","volume":"87","author":"Mettang","year":"2015","journal-title":"Kidney Int"},{"key":"B35-20230813","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1152\/jn.00827.2013","article-title":"Voxel-based morphometry and arterial spin labeling fMRI reveal neuropathic and neuroplastic features of brain processing of itch in end-stage renal disease.","volume":"112","author":"Papoiu","year":"2014","journal-title":"J Neurophysiol"},{"key":"B36-20230813","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s12882-015-0043-3","article-title":"Pharmacokinetics of nalbuphine hydrochloride extended release tablets in hemodialysis patients with exploratory effect on pruritus.","volume":"16","author":"Hawi","year":"2015","journal-title":"BMC Nephrol"},{"key":"B37-20230813","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.1093\/ndt\/gft473","article-title":"Measuring the quality of renal care: Things to keep in mind when selecting and using quality indicators.","volume":"29","author":"van der Veer","year":"2014","journal-title":"Nephrol Dial Transplant"}],"container-title":["Clinical Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01277230-201712000-00013","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T13:37:15Z","timestamp":1786369035000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01277230-201712000-00013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,18]]},"references-count":36,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.2215\/cjn.03280317","relation":{},"ISSN":["1555-9041","1555-905X"],"issn-type":[{"value":"1555-9041","type":"print"},{"value":"1555-905X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,18]]}}}