Prevalence and influencing factors of pruritus in maintenance hemodialysis patients in China: a meta-analysis

Abstract

Objective

To explore the prevalence and influencing factors of Chronic Kidney Disease-associated Pruritus (CKD-aP) among maintenance hemodialysis (MHD) patients in China through a meta-analysis.

Methods

A systematic computerized search was conducted across ten databases, including CNKI, VIP, Wanfang, PubMed, Web of Science, and The Cochrane Library, to identify studies on the prevalence and influencing factors of pruritus among Chinese hemodialysis patients up to January 2025. Two independent graduate students conducted literature screening, data extraction, and bias risk assessment for the included studies. Data analysis was performed using Stata 17.0 software.

Results

A comprehensive meta-analysis of 27 studies involving 10,346 participants identified 5,968 cases of CKD-ap among hemodialysis patients, examining 30 potential influencing factors. The meta-analysis revealed that the prevalence of CKD-ap in China was 52%, with 26% of patients experiencing mild CKD-ap, 22% moderate CKD-ap, and 8% severe CKD-ap. Factors associated with an increased risk of CKD-ap included duration of dialysis treatment (OR = 1.51, 95% CI: 1.15–1.88), primary disease (OR = 1.43, 95% CI: 0.87–1.99), dry skin disease (OR = 2.46, 95% CI: 1.74–3.19), phosphorus (OR = 1.18, 95% CI: 0.55–1.81), Ca - P product (OR = 2.18, 95% CI: 1.14–3.22), C - reactive protein (CRP) (OR = 1.14, 95% CI: 0.78–1.51), iPTH (OR = 2.45, 95% CI: 0.81–4.09), β₂ - MG(OR = 2.24, 95% CI: 0.94–3.53), and SCr (OR = 1, 95% CI: 1.001–1.005). Conversely, factors including blood calcium levels (OR = 0.33, 95% CI: 0.31–0.35), dialysis modality (OR = 0.54, 95% CI: 0.23–0.85), and Kt/V (OR = 0.60, 95% CI: 0.24–0.96) were associated with a reduced risk of CKD-ap.

Conclusion

This meta-analysis demonstrates a high prevalence of CKD-ap among Chinese MHD patients, underscoring the urgent need for improved awareness, preventive interventions, and management strategies in clinical practice.

Clinical trial number

Not applicable.

Trial number

The study was registered in PROSPERO: No. CRD42024562865.