Chronic Itching Worsens Fatigue and Reduces Quality of Life in 50% of Hemodialysis Patients

Patient with Itchy Skin

Results of new study published in National Kidney Foundation’s American Journal of Kidney Disease

(Aug. 16, 2023, New York, NY) — Moderate to severe itching, or pruritus, remains a common and bothersome problem among patients receiving maintenance hemodialysis. The finding comes from a new study published today online in the National Kidney Foundation’s (NKF) premier biomedical journal, the American Journal of Kidney Diseases (AJKD). Almost 8,000 hemodialysis patients in 21 different countries were surveyed, and approximately one in every two patients reported moderate to severe pruritus, over a one-year period. For those with pruritus at baseline, 50% reported the itching persisted over one year. The development of new pruritus during the one-year study period was associated with higher rates of depression, poor sleep, fatigue, and delayed recovery after a dialysis session. Patients with pruritus were also more likely to report low quality of life. 

Dr. Nidhi Sukul, Lead Author and Assistant Chief of the Renal Section at the Veterans Affairs Ann Arbor Health Care System and an Assistant Professor in the Division of Nephrology at the University of Michigan, states, “This international study is the largest of its kind to evaluate the longitudinal course of pruritus and its associated outcomes.  Providers often underestimate the prevalence of pruritus.  Given the study findings, patients undergoing hemodialysis should have regular assessment of pruritus and be evaluated for treatment.”

The study findings by Sukul et al emphasize the need for better consensus among providers to standardize frequent assessment of pruritus and pursue effective treatments for those experiencing bothersome symptoms. Routine queries of patient-reported outcomes, including pruritus, may help improve the quality of life of patients receiving maintenance hemodialysis.

David A. Perchinsky, a patient receiving hemodialysis at the DaVita clinic in Lakeville Minnesota for the past four years characterizes pruritus as a “miserable experience.”  While he no longer suffers from pruritus, he says pruritus affected “my ability to sleep calmly and remain still while having my dialysis sessions.”

The full study, Pruritus in Hemodialysis Patients: Longitudinal Associations with Clinical and Patient-Reported Outcomes by Nidhi Sukul, Junhui Zhao, Ronald L Pisoni, Sebastian Walpen, Thilo Schaufler, Elham Asgari, Fitsum Guebre-Egziabher, Li Zho, Mohammed Abdulrahman Al-Ghonaim, MD8,9, Kosaku Nitta, MD10, Bruce M Robinson, and Angelo Karaboyas, was published in the American Journal of Kidney Diseases (2023) and is available today online.

For more information about pruritus and kidney disease, visit


About Kidney Disease

In the United States, 37 million adults are estimated to have kidney disease, also known as chronic kidney disease (CKD)—and approximately 90 percent don’t know they have it.  About 1 in 3 adults in the U.S. are at risk for kidney disease.  Risk factors for kidney disease include: diabeteshigh blood pressureheart diseaseobesity, and family history. People of Black/African American, Hispanic/Latino, American Indian/Alaska Native, Asian American, or Native Hawaiian/Other Pacific Islander descent are at increased risk for developing the disease. Black/African American people are about 4 times as likely as White people to have kidney failure.  Hispanics/Latinos are 1.3 times more likely than non-Hispanics to have kidney failure.

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About the National Kidney Foundation

The National Kidney Foundation (NKF) is the largest, most comprehensive, and longstanding patient-centric organization dedicated to the awareness, prevention, and treatment of kidney disease in the U.S. For more information about NKF, visit