HbA1c Is Related with Uremic Pruritus in Diabetic and Nondiabetic Hemodialysis Patients

Objective: Uremic pruritus (UP) remains a frequent problem in hemodialysis (HD) patients and is related to mortality. Poor glycemic control, as evaluated by hemoglobin A1c (HbA1c), is also associated with morbidity and mortality in HD patients. In this study, we investigated the relationship between UP and HbA1c in HD patients. Methods: Sociodemographic, clinical, and laboratory variables, depressive symptoms, and health-related quality of life were assessed. Severity of UP was evaluated by visual analogue scale (VAS). The scale consisted of a 10 cm horizontal line marked from 0 (denoting no itch) to 10 (denoting worst possible imaginable itch). Results: Totally, 75 patients (male/female, 41/34; diabetic/nondiabetic, 29/46; age, 51.9 +/- 13.5 years) were included. The VAS pruritus score was higher in diabetic patients compared with nondiabetic patients (4.7 +/- 2.8 vs. 3.0 +/- 1.0, p : 0.015). In diabetics, VAS pruritus score was independently related with calcium-phosphorus product (beta : +0.637, p < 0.0001), intact parathyroid hormone (beta : +0.343, p : 0.017), HbA1c (beta : +0.310, p : 0.027), and Beck depression score (beta : +0.474, p : 0.002). In nondiabetics, VAS pruritus score was independently related with calcium-phosphorus product (beta: +0.486, p : 0.004), intact parathyroid hormone (beta : +0.302, p : 0.041), and HbA1c (beta : +0.341, p : 0.033). In the whole patient group, VAS pruritus score was independently related with calcium-phosphorus product (beta : +0.372, p : 0.001), intact parathyroid hormone (beta : +0.241, p : 0.008), HbA1c (beta : +0.227, p : 0.031), and Beck depression score (beta : +0.298, p : 0.003). Conclusions: In both diabetic and nondiabetic patients, HbA1c is closely related with pruritus in HD patients.