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Patients with chronic kidney disease (CKD) undergoing hemodialysis often experience significant itch secondary to their condition and a subsequent reduction in their overall quality of life. Current treatments are underwhelming, necessitating the search for new, effective therapeutic options to combat itch in this population. The purpose of this review is to explore the available data for the use of intravenous difelikefalin in patients with CKD undergoing hemodialysis. The pathophysiology of CKD-associated itch is multifactorial, with one proposed mechanism involving an imbalance in the endogenous opioid system, favoring upregulation of itch-activating μ-opioid receptors (MORs) and downregulation of itch-inhibiting κ-opioid receptors (KORs). Dysregulation of the immune system is also involved. Difelikefalin is a recent FDA approved treatment that functions as peripherally acting KOR agonist, targeting this imbalance in the endogenous opioid system seen in CKD patients with itch and having an anti-inflammatory effect on immune cells. Clinical data on intravenous difelikefalin is promising regarding its ability to reduce itch in CKD patients on hemodialysis and improve patient quality of life, with few, mild adverse side effects. As intravenous difelikefalin becomes more widely used in the clinical setting, further studies assessing long-term efficacy and safety will be needed. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) is a worldwide public health problem related to adverse results of end-stage renal disease (ESRD), kidney failure, cardiovascular disease (CVD), and premature death. The study is aimed to investigate the knowledge, attitude, and practice toward the prevention and early detection of chronic kidney disease. Two ordinal variables and one nominal response variable with 20 predictor variables were independently fitted. Ordinal multicategories , such as proportional odds, continuation ratio, and partial proportional models for attitude and practice, whereas the baseline multicategory logit model for knowledge was fitted. The findings implied that some predictors have a significant effect on attitude, whereas other covariates have a significant effect on practice. Moreover, as there are two independent logit models for the nominal response, in the first logit model Monthly income and Diabetes2, whereas in the second logit model, Smo_R_CKD3 and Diabetes2 have a significant effect on knowledge. In conclusion, more educated ones have more knowledge and attitude toward the prevention and early detection of chronic kidney disease, also more likely to perform preventive and early detecting practices. People are inadequately informed on the prevention and early detection of CKD, especially those who are with low income, are at risk of developing CKD and its complications. [ABSTRACT FROM AUTHOR]

To investigate the prevalence of depression and anxiety in patients undergoing maintenance hemodialysis (MHD) in Hohhot, a large city on the northern border of China, and to identify independent risk factors for depression and anxiety in these patients. Patients receiving MHD for >3 months were enrolled in the four largest hemodialysis centers between September 2020 and December 2020. Depression and anxiety were assessed using the Zung self-rated depression scale (SDS) and Zung self-rated anxiety scale (SAS), respectively, with demographic and other data collected for logistic regression analyses. Among 305 MHD patients included in this study, the prevalence of depression was 55.1%, including 27.5%, 21.0%, and 6.6% with mild, moderate and severe cases, respectively. The prevalence of anxiety was 25.9%, with 20.0%, 4.6%, and 1.3% having mild, moderate, and severe cases, respectively. An independent protective factor for depression was family income of ≥1415 US dollars/month relative to <157 US dollars/month (odds ratio [OR] 0.209, 95% confidence interval [CI] 0.065–0.673), and predictors of depression included ≥3 comorbidities (OR 18.527, 95% CI 1.674–205.028) and severe pruritus (OR 15.971, 95% CI 5.173–49.315). Independent predictors of anxiety included infrequent exercise (OR 3.289, 95% CI 1.411–7.664) and severe pruritus (OR 5.912, 95% CI 1.733–20.168). The correlation between depression and anxiety in these patients was significant (rs = 0.775, p < 0.001). MHD patients in Northern China had high prevalence rates of depression (55.1%) and anxiety (25.9%). Lower family income, more comorbidities, and a higher degree of pruritus were predictors of depression, while infrequent exercise and severe pruritus were predictors of anxiety. Depression correlated significantly with anxiety. Attention should be given to family income, comorbidity, exercise, and pruritus severity for improved management of depression and anxiety among MHD patients. [ABSTRACT FROM AUTHOR]