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Purpose <p>To evaluate the occurrence of uremic pruritus among peritoneal dialysis (PD) patients and explore its correlation with serum iron levels.</p> Methods <p>A cross-sectional study was carried out on 189 PD patients at a single center in China. The severity of pruritus was assessed through the validated 5-D Itch Scale questionnaire. The relationship between clinical factors and pruritus was examined using multivariate logistic regression, restricted cubic spline analysis, piecewise regression, and cluster analysis of iron metabolism patterns.</p> Results <p>Moderate/severe pruritus affected 27.5% of participants, mainly on lower limbs (52.9%) and back (46.6%). Serum iron was significantly higher in the moderate/severe pruritus group (18.43 ± 8.50 vs. 15.84 ± 6.09 µmol/L, <i>p</i> = 0.029). After adjustments, each standard deviation increase in serum iron corresponded to higher odds of moderate/severe pruritus (odds ratio (OR) = 1.45, 95% confidence interval (CI):1.03–2.08, <i>p</i> = 0.037). Analysis revealed a threshold association(<i>p</i> = 0.043) with an inflection point at 13.7µmol/L, above which each unit increase in serum iron raised pruritus odds by 10% (OR = 1.10, 95%CI:1.03–1.18, <i>p</i> = 0.006). Cluster analysis identified that patients with high transferrin saturation (TSAT), moderate ferritin, and high serum iron had the highest pruritus prevalence (52.8%).</p> Conclusion <p>In PD patients, we identified a threshold effect of serum iron on uremic pruritus. Iron levels above 13.7 µmol/L independently worsened pruritus, especially in patients with high TSAT, moderate ferritin, and high serum iron, where prevalence reached 52.8%. These findings highlight the importance of assessing iron status and personalized management.</p>

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Nonlinear association between serum iron levels and moderate-to-severe uremic pruritus in peritoneal dialysis patients: a cross-sectional study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月24日

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  • Wenjie Yu,
  • Jing He,
  • Zhiyao Bao,
  • Zhaoting Li,
  • Chunyan Zhang,
  • Jingyuan Xie,
  • Hong Ren,
  • Xiaomin Huang,
  • Tian Xu

摘要

Purpose

To evaluate the occurrence of uremic pruritus among peritoneal dialysis (PD) patients and explore its correlation with serum iron levels.

Methods

A cross-sectional study was carried out on 189 PD patients at a single center in China. The severity of pruritus was assessed through the validated 5-D Itch Scale questionnaire. The relationship between clinical factors and pruritus was examined using multivariate logistic regression, restricted cubic spline analysis, piecewise regression, and cluster analysis of iron metabolism patterns.

Results

Moderate/severe pruritus affected 27.5% of participants, mainly on lower limbs (52.9%) and back (46.6%). Serum iron was significantly higher in the moderate/severe pruritus group (18.43 ± 8.50 vs. 15.84 ± 6.09 µmol/L, p = 0.029). After adjustments, each standard deviation increase in serum iron corresponded to higher odds of moderate/severe pruritus (odds ratio (OR) = 1.45, 95% confidence interval (CI):1.03–2.08, p = 0.037). Analysis revealed a threshold association(p = 0.043) with an inflection point at 13.7µmol/L, above which each unit increase in serum iron raised pruritus odds by 10% (OR = 1.10, 95%CI:1.03–1.18, p = 0.006). Cluster analysis identified that patients with high transferrin saturation (TSAT), moderate ferritin, and high serum iron had the highest pruritus prevalence (52.8%).

Conclusion

In PD patients, we identified a threshold effect of serum iron on uremic pruritus. Iron levels above 13.7 µmol/L independently worsened pruritus, especially in patients with high TSAT, moderate ferritin, and high serum iron, where prevalence reached 52.8%. These findings highlight the importance of assessing iron status and personalized management.