Effect of high flux hemodialysis combined with low calcium dialysate on skin pruritus and sleep quality in patients with end-stage renal disease complicated with skin pruritus
Objective To evaluate the effect of high flux hemodialysis(HFHD)combined with low calcium dialysate on skin pruritus and sleep quality in patients with end-stage renal disease(ESRD)complicated with skin pruritus.Methods 76 ESRD patients complicated with skin pruritus were enrolled and randomly divided into a study group(n=38)and a control group(n=38).The control group received HFHD and normal calcium dialysate,while the study group received HFHD combined with low calcium dialysate.Both groups were compared in terms of skin itching(scores for skin itching severity and range),laboratory indexes[serum parathyroid hormone(PTH),blood calcium,blood phosphorus],and sleep quality[Pittsburgh Sleep Quality Index Scale(PSQI)score and incidence of sleep disorders].Results Before treatment,there was no statistical difference in scores for skin itching severity and range between the study group and the control group(P＞0.05).After 8 weeks of treatment,the scores for skin itching severity and range in the two groups were significantly lower than those before treatment;the scores for skin itching severity and range in the study group were(1.4±0.6)and(1.5±0.6)points,which were lower than(2.1±1.0)and(2.3±1.1)points in the control group(P＜0.05).Before treatment,there were no significant differences in serum PTH,serum calcium and serum phosphorus between the study group and the control group(P＞0.05).After 8 weeks of treatment,the serum PTH and blood phosphorus levels in both groups were significantly lower than those before treatment;the study group had serum PTH of(265.4±54.2)pg/ml and blood phosphorus of(1.5±0.4)mmol/L,which were significantly lower than(294.9±62.7)pg/ml and(1.8±0.6)mmol/L in the control group(P＜0.05).The serum calcium level of the study group was(2.1±0.3)mmol/L after 8 weeks of treatment,which was lower than(2.5±0.3)mmol/L before treatment(P＜0.05),but there was no significant difference between the two groups after 8 weeks of treatment(P＞0.05).Before treatment,there was no significant difference in the PSQI score and the incidence of sleep disorders between the study group and the control group(P＞0.05).After 8 weeks of treatment,PSQI score and incidence of sleep disorders in both groups were lower than those before treatment;the study group had PSQI score of(5.8±2.7)points and incidence of sleep disorders of 26.3%,which were lower than(9.2±3.5)points and 50.0% in the control group(P＜0.05).Conclusion HFHD combined with low calcium dialysate can improve skin pruritus and sleep quality of ESRD patients with skin pruritus.
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