Retentissement du Prurit sur la Qualité de Vie des Patients Hémodialysés Chroniques

Emmanuel Armand Kouotou, Joël Tameyi Tatsa, François Kaze Folefack, Isidore Sieleunou, Jobert Richie Nansseu, Habakkuk Azinyui Yumo, Elie Claude Ndjitoyap Ndam

Abstract


ABSTRACT
BACKGROUND. Pruritus is frequent in chronic hemodialysed patient and alters his quality of life. His pathophysiology is unclarified and his management a challenge for nephrologist.
OBJECTIVE. To assess the impact of pruritus on quality of life of maintenance hemodialysis patients in our setting.
MATERIAL AND METHODS. This was a cross-sectional study, carried from February to May 2014 in two Yaoundé hemodialysis centers, involving any patient on maintenance hemodialysis for at least three months who self-administer a multi-questionnaire specific on uremic pruritus, including Skindex-10 score, Brief Itch Inventory and itch medical outcome survey of sleep. Chi square and t-student tests or equivalents were used for statistical analysis. The level of significance was set at p<0.05.
RESULTS. We recruited 42 patients, 32 (76,2%) male, with a mean age of 51 ± 13 years and a mean duration in dialysis of 40 ± 32 months. Pruritus was moderate to severe in 25 (59,5%) patients. The intensity of pruritus was associated to all parameters of quality of life studied (p < 0,0001). The alteration of quality of life secondary to pruritus severity was associated with advanced age (>50 years), low education level, shorter duration in dialysis (<1 year) and anuria.
CONCLUSION. This study reveals an important quality of life alteration of chronic hemodialysed patients regarding daylight activities and sleep.

RÉSUMÉ
INTRODUCTION. Le prurit est fréquent chez l’hémodialysé chronique et altère sa qualité de vie. Sa physiopathologie est mal élucidée et sa prise en charge reste un défi.
OBJECTIF. Évaluer le retentissement du prurit sur la qualité de vie des hémodialysés chroniques dans notre milieu.
MATERIEL ET METHODES. Il s’agissait d’une étude transversale, menée de Février à Mai 2014 dans les deux centres d’hémodialyse de Yaoundé, incluant tout hémodialysé chronique depuis au moins 3 mois qui s’auto-administrait un multi-questionnaire spécifique au prurit urémique, comprenant les scores Skindex-10, « Brief Itch Inventory », et «itch medical outcome survey of sleep ». Les tests de Chi carré et t- de Student ou équivalents étaient utilisés pour l’analyse statistique. Le seuil de signification était fixé à p<0,05.
RESULTATS. Nous avons colligé 42 patients dont 32 (76,2%) hommes, d’un âge moyen de 51 ± 13 ans et une durée moyenne en dialyse de 40 ± 32 mois. Le prurit était modéré à sévère chez 25 (59,5%) patients. L’intensité du prurit était associée à tous les paramètres de l’altération de la qualité de vie étudiés (p < 0,0001). L’altération de la qualité de vie secondaire à la sévérité du prurit était associée à l’âge avancé (>50ans), au faible niveau d’instruction, à la courte durée en dialyse (<1 an) et à l’anurie.
CONCLUSION. Cette étude révèle une altération importante de la qualité de vie des hémodialysés chroniques qui porte sur les activités quotidiennes et le sommeil.


Keywords


Pruritus; maintenance hemodialysis; quality of life; Cameroon

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