A NEW study has shed light on the burden of chronic kidney disease-associated pruritus among patients undergoing home haemodialysis, highlighting its significant impact on quality of life while raising questions about how symptom severity relates to patient experience.
The cross-sectional study analysed 59 patients receiving home haemodialysis to better understand how commonly CKD-associated pruritus occurs in this setting and how it affects patient-reported outcomes. While home haemodialysis is often associated with improved flexibility and clinical benefits compared to in-centre treatment, its relationship with distressing symptoms such as pruritus has remained underexplored.
Researchers found that 31% of participants (n=18) experienced CKD-associated pruritus, a prevalence comparable to that reported in centre-based haemodialysis populations. This suggests that despite the advantages of home-based care, pruritus remains a persistent and clinically relevant issue.
Chronic Kidney Disease Pruritus Linked to Poorer Quality of Life
Importantly, patients affected by pruritus reported significantly poorer quality of life compared with those without symptoms. Using the EQ-5D instrument, quality of life scores were notably lower in the pruritus group (0.760 vs. 1.00, p=0.042), reinforcing the substantial burden this symptom places on daily functioning and wellbeing.
However, the study also revealed a more nuanced finding: the severity of itching, measured using the 5-D itch scale, was not significantly associated with patient-reported outcomes, including quality of life, anxiety, depression, or sleep disturbances. This indicates that even milder forms of pruritus may have a disproportionate impact on patients, or that factors beyond itch intensity contribute to overall wellbeing.
Improving Management of CKD Pruritus in Home Haemodialysis
The authors emphasise that these findings point to a complex and not yet fully understood relationship between pruritus and patient experience in home haemodialysis. They call for larger, longitudinal studies to better characterise these associations and to inform more effective management strategies.
As home haemodialysis continues to expand globally, recognising and addressing symptoms such as CKD-associated pruritus will be critical to improving patient-centred outcomes and ensuring that the benefits of home-based care are fully realised.
Reference
Nayak KK et al. Chronic kidney disease-associated pruritus in patients on home haemodialysis. Nephrology. 2026;31(5):e70208.
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