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Hepatol Res. 2018 Feb;48(3):E252-E262. doi: 10.1111/hepr.12978. Epub 2017 Oct 10.

Prevalence of pruritus in patients with chronic liver disease: A multicenter study.

Author information

1
Liver Center, Saga University Hospital, Saga, Japan.
2
Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
3
Clinical Research Center, Saga University Hospital, Saga, Japan.
4
Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Kanagawa, Japan.
5
Department of Gastroenterology and Hepatology, Kochi Medical School, Kochi, Japan.
6
Department of Gastroenterology and Hepatology, JA Hiroshima General Hospital, Hiroshima, Japan.
7
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan.
8
Department of Gastroenterology and Hepatology, Osaka City Juso Hospital, Osaka, Japan.
9
Department of Hepatology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
10
Department of General Internal Medicine 2, General Medical Center, Kawasaki Medical School, Okayama, Japan.
11
Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
12
Division of Hepatology and Pancreatology, Department of Internal Medicine, Aichi Medical University, Aichi, Japan.
13
Center for Digestive and Liver Diseases, Nara City Hospital, Nara, Japan.
14
Section of Clinical Cooperation System, Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University, Saga, Japan.

Abstract

AIM:

Pruritus is a common comorbidity in chronic liver disease. The aim of this study was to clarify the prevalence of pruritus and its characteristics in patients with chronic liver disease.

METHODS:

A total of 1631 patients with chronic liver disease who attended one of nine joint-research facilities from January to June 2016 were enrolled. We investigated the prevalence of pruritus, itch location, itch duration, daily itch fluctuation, seasonal itch exacerbation, treatment drugs, and therapeutic effects using a medical interview questionnaire.

RESULTS:

The median age was 66 years and 890 (54.6%) patients were women. The prevalence of pruritus was 40.3% (658/1631), and it differed according to the underlying liver disease. The most frequent body location for pruritus was on the back (63.1%). Pruritus duration was more than 6 months in 252 (38.3%) patients. The severity of pruritus, assessed using a visual analog scale, was higher during the day than at night (median, 4 vs. 3, P < 0.001). Seasonal exacerbation was observed in 296 (45.0%) patients. Although 301 (45.7%) patients were treated with antipruritic agents, 57.8% (174/301) patients reported an insufficient effect. Active hepatitis B virus infection (odds ratio [OR], 2.51; P = 0.043), primary biliary cholangitis (OR, 3.69; P = 0.018), diabetes (OR, 1.57; P = 0.010), and aspartate aminotransferase ≥60 U/L (OR, 2.06; P = 0.011) were independent factors associated with pruritus.

CONCLUSION:

The prevalence of pruritus varies according to the chronic liver disease etiology. Underlying liver disease, aspartate aminotransferase ≥60 U/L, and comorbid diabetes are factors associated with pruritus in patients with chronic liver disease.

KEYWORDS:

cirrhosis; diabetes; hepatitis; opioid; quality of life

PMID:
28877392
DOI:
10.1111/hepr.12978

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