Insights Into Current Practices and Unmet Needs Relating to CKD-Associated Pruritus: Results From a Canadian Nephrologist Survey
Bibliographic record
Abstract
Background: Chronic kidney disease-associated pruritus (CKD-aP) is a common condition in patients with CKD undergoing hemodialysis (HD). In this real-world study, Canadian nephrologists were surveyed to gain insight into current practices and unmet needs related to the treatment of CKD-aP. Methods: Quantitative data regarding the perception of current treatment practices for CKD-aP were collected in November and December 2021 by a 20-minute survey completed by 62 nephrologists across Canada. Respondents' level of agreement was assessed using a 7-point scale. Results: In current practice, the mean perceived prevalence of CKD-aP in HD patients was 30.5%. Of these, 33.6% and 18.3%, respectively, experience moderate or severe CKD-aP. CKD-aP was most frequently identified (75.8% of cases) through patients complaining of itch to the multidisciplinary health care team. In clinical practice 63% of respondents currently do not use formal scales to diagnose and assess CKD-aP. Treatments used for severe and moderate CKD-aP are shown in the table. Nephrologists used topical moisturizers / emollients (85%), oral antihistamines (14%), and gabapentinoids (2%) as first-line treatments. Nephrologists reported 42% of patients with severe CKD-aP and 41% with moderate CKD-aP do not respond to treatment. Most nephrologists (94%) agreed there is a need for new treatments specifically designed to address CKD-aP, 68% agreed they do not expect to resolve a patient's CKD-aP with currently available treatments, 89% agreed CKD-aP is challenging to treat, and 69% agreed there is a need for guidelines for the treatment of CKD-aP. Conclusions: This real-world Canadian study of nephrologists showed that CKD-aP is challenging to treat and many patients do not respond to currently-available treatments. There is an urgent unmet need for new, more effective treatments and for guidelines to aid nephrologists in selecting therapy for their patients with CKD-aP. Funding: Commercial Support - OtsukaTreatment Choices
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".