Qualitative interviews on chronic pruritus in haemodialysis patients.

patients per year depend on HD (2). It is estimated that worldwide more than 2 million people suffer from end-stage renal disease (ESRD) that requires HD. It is predicted that this number will continue to increase, making ESRD a significant public health issue (3). Chronic pruritus (CP) is a frequent but often overlooked symptom in HD (4) that affects patients' well-being and reduces the quality of life (Qol) (5–8). A few existing studies suggest CP to occur in 20–75% of HD patients (6, 7, 9) but there are strong variations according to country and dialysis facility (9). Although HD patients already suffer from strong limitations in their everyday life and are often affected by depression (9, 10), qualitative data on fears/burdens, needs and healthcare situation in HD patients suffering from CP are sparse. In a previous study we already showed the difficulties CP patients have in handling and coping with this symptom (11). Here we investigate CP patients with and without HD concerning the perception of CP and patients' special needs: how do these patients feel, what is important for them and how do they perceive the symptom of CP? MATERIAL AND METHODS We conducted semi-structured interviews using open-ended questions in patients who had consulted the itch clinic at the University Hospital Heidelberg between November 2012 and January 2013. The study was conducted in accordance with the World Medical Association's Declaration of Helsinki. Fourteen patients suffering from CP took part in the study. Eight of them were HD patients, 6 patients suffered from CP caused by dermatoses or CP of mixed (non-systemic) origin without any comorbidity. Six patients were women and 8 were men. The age range was 28–88 years. The mean age was 67.4 years. One interview lasted on average 1–2 h. Prior to the interview we asked all patients to fill in questionnaires that are used in nephrological and dermatological practice: (i) The KDQOL-SF TM (Kidney Disease Quality of Life Short Form), a special instrument to measure QoL in patients with present kidney disease (12). (ii) The ItchyQoL, a pruritus-specific QoL-questionnaire, which is validated in the German language (13). All of the patients completed the questionnaires. However, patients without HD/ESRD did not answer the questions concerning HD or kidney disease. Additionally , patients were asked open questions regarding their QoL, living/health conditions and problems/needs they receive due to their kidney disease and CP. To evaluate the interviews we …