Evaluation of Interleukin-31 Serum Levels in Patients with Chronic Kidney Disease on Hemodialysis with and without Uremic Pruritus

Authors

  • Mustafa Sh. Abdulqahar Al-Fallujah Teaching Hospital for Maternity and Children, Al-Anbar Health Directorate, Al-Anbar, Iraq. https://orcid.org/0009-0004-8020-2135
  • Ali A. Kasem Department of Clinical Laboratory Science, College of Pharmacy, the University of Baghdad, Baghdad, Iraq. https://orcid.org/0000-0003-0674-0969

DOI:

https://doi.org/10.32007/jfacmedbaghdad.6632329

Keywords:

Chronic kidney disease, Hemodialysis, Itching, InterlukinL-31, Uremic Pruritus

Abstract

Background: Interleukin-31 has been linked with developing and maintaining pruritus in various dermatological and non-dermatological diseases.

Objectives: To evaluate interleukin-31 serum levels in hemodialysis patients with and without uremic pruritus as a potential contributor.

Methods: This cross-sectional study involved ninety adult chronic kidney disease patients on hemodialysis. All of the enrolled patients were on a three-times/week hemodialysis regimen. Patients were divided into two groups of 45 patients each. Group 1 involved those with pruritus and Group 2 involved those free of pruritus; based on the itching severity scale (ISS). Serum levels of interleukin-31, intact parathormone, urea, creatinine, and calcium were assessed before the hemodialysis session. Serum interleukin-31 levels were also assessed after the hemodialysis session. The statistical analysis was performed using the Statistical Package for Social Science (SPSS). The median and interquartile range (IQR) were used to present data on the continuous variables. Mann-Whitney test was used to compare the differences between medians of the two groups, and Wilikson test was used to compare the differences between medians of IL-31 before and after hemodialysis. Spearman's correlation was employed to assess the correlation among the studied variables. A P-value less than 0.05 was considered significant.

Results: In the pre-dialysis samples, serum levels of interleukin-31 in patients with uremic pruritus were not significantly different from those in patients without uremic pruritus [1361.55 (741.96) pg/mL and 1395.75(624.75) pg/mL, respectively; P=0.36]. However, patients with uremic pruritus had higher serum creatinine levels than patients without uremic pruritus [9.8(5.5) mg/dL and 8.15(3.18) mg/dL, respectively; P=0.02]. The two groups had no significant differences in intact parathormone, calcium, or urea serum levels. In both of the study groups, serum interleukin-31 levels in patients with and without uremic pruritus were significantly reduced by hemodialysis. In the post-dialysis samples, serum interleukin-31 levels in patients with uremic pruritus were not statistically different from those in patients without uremic pruritus [864 (164.58) pg/mL and 879.7(84.19) pg/mL, respectively; P=0.83].

Conclusions: The association of serum interleukin-31 levels with uremic pruritus in chronic kidney disease CKD patients on hemodialysis need further verification.

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References

.Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022.Kidney International Supplements 2022;12:7-11.

https://doi.org/10.1016/j.kisu.2021.11.003

.Alewe Mijbel N, Jamil Ibrahim S. The Relationship between Levels of Serum Vit. D and Kidney Function in Diabetic Nephropathy Iraqi Patient. Journal of the Faculty of Medicine Baghdad 2023;65:93-7.

https://doi.org/10.32007/jfacmedbagdad.1979

.Aljorani RH, Saleh ES, Al Mohammadawi KGH. Correlation of Kidney Injury Molecule-1 and Nephrin Levels in Iraqi Patients with Diabetic Nephropathy. Al-Rafidain Journal of Medical Sciences 2023;5:99-104.https://doi.org/10.54133/ajms.v5i.167

Talib AF, Mudhafar ZN. The role of clinical pharmacist in reducing drug-related problems in hemodialysis patients. Iraqi Journal of Pharmaceutical Sciences 2021;29:223-30.

https://doi.org/10.31351/vol29iss2pp223-230

Puneet Agarwal 1, Vinita Garg 2, Priyanka Karagaiah 3, Jacek C. Szepietowski 4, and Mohamad Goldust 5,* SG. Chronic Kidney Disease-Associated Pruritus 2021:1-15.

https://doi.org/10.3390/toxins13080527

Al-khafaji MSR, Al-mayahi AMM. Assessment of Hemodialysis Patients ' knowledge Concerning Uremic Pruritus 2023;2:127-35.

https://doi.org/10.58897/z8gkxh38

Cheng AY, Wong LS. Uremic Pruritus: From Diagnosis to Treatment. Diagnostics 2022;12:14.

https://doi.org/10.3390/diagnostics12051108

Kabashima K, Irie H. Interleukin-31 as a Clinical Target for Pruritus Treatment. Frontiers in Medicine 2021;8:1-10.

https://doi.org/10.3389/fmed.2021.638325

Borgia F, Custurone P, Li Pomi FL, Cordiano R, Alessandrello C, Gangemi S. IL-31: State of the Art for an Inflammation-Oriented Interleukin. International Journal of Molecular Sciences 2022;23:1-20.

https://doi.org/10.3390/ijms23126507

Xu J, Wang Y, Khoshdeli M, et al. IL-31 levels correlate with pruritus in patients with cholestatic and metabolic liver diseases and are farnesoid X receptor responsive in NASH. Hepatology 2023;77:20-32.https://doi.org/10.1002/hep.32599

Fakree NK, Hashim ZM, Muhsen AAS, Hashim NM. Some Pro and Anti-Inflammatory Cytokines in Children with Tonsillitis and their Correlations with Vitamin D Deficiency. Iraqi Journal of Pharmaceutical Sciences 2022;31:194-201.

https://doi.org/10.31351/vol31iss1pp194-201

Oweis AO, AL-Qarqaz F, Bodoor K, et al. Elevated interleukin 31 serum levels in hemodialysis patients are associated with uremic pruritus. Cytokine 2021;138:155369.

https://doi.org/10.1016/j.cyto.2020.155369

Świerczyńska K, Krajewski PK, Nowicka-Suszko D, Białynicki-Birula R, Krajewska M, Szepietowski JC. The Serum Level of IL-31 in Patients with Chronic Kidney Disease-Associated Pruritus: What Can We Expect? Toxins 2022;14:1-9. https://doi.org/10.3390/toxins14030197

Erickson S, Kim BS. Research Techniques Made Simple: Itch Measurement in Clinical Trials. Journal of Investigative Dermatology 2019;139:264-269.e1.

https://doi.org/10.1016/j.jid.2018.12.004

Santos-Alonso C, Maldonado Martín M, Sánchez Villanueva R, et al. Pruritus in dialysis patients. Review and new perspectives. Nefrología (English Edition) 2022;42:15-21.

https://doi.org/10.1016/j.nefroe.2022.02.004

Świerczyńska-Mróz K, Nowicka-Suszko D, Fleszar MG, et al. Serum Level of Protein-Bound Uraemic Toxins in Haemodialysis Patients with Chronic Kidney Disease-Associated Pruritus: Myths and Facts. Journal of Clinical Medicine 2023;12.

https://doi.org/10.3390/jcm12062310

Verduzco HA, Shirazian S. CKD-Associated Pruritus: New Insights Into Diagnosis, Pathogenesis, and Management. Kidney International Reports 2020;5:1387-402.

https://doi.org/10.1016/j.ekir.2020.04.027

Schricker S, Kimmel M. Unravelling the pathophysiology of chronic kidney disease-associated pruritus. Clinical Kidney Journal 2021;14:I23-31.https://doi.org/10.1093/ckj/sfab200

Rehman IU, Chan KG, Munib S, Lee LH, Khan TM. The association between CKD-associated pruritus and quality of life in patients undergoing hemodialysis in Pakistan: A STROBE compliant cross-sectional study. Medicine (United States) 2019;98.

https://doi.org/10.1097/MD.0000000000016812

Weiss M, Mettang T, Tschulena U, Passlick-Deetjen J, Weisshaar E. Prevalence of chronic itch and associated factors in hemodialysis patients: A representative cross-sectional study. Acta Dermato-Venereologica 2015;95:816.21.

https://doi.org/10.2340/00015555-2087

Modi ZJ, Waldo A, Selewski DT, Troost JP, Gipson DS. Inpatient Pediatric CKD Health Care Utilization and Mortality in the United States. American Journal of Kidney Diseases 2021;77:500-8. https://doi.org/10.1053/j.ajkd.2020.07.024

Khudhair A, Naama KZN, Khaleel A, Saadi Y. Acute Kidney Injury in Neonates: A Single-Center Experience. Journal of the Faculty of Medicine Baghdad 2023;65:150-5.

https://doi.org/10.32007/jfacmedbagdad.2048

Alridha AMA, Kadhim DJ, Alkhazrajy AHA. The Potential of Vitamin-D-Binding Protein as an Urinary Biomarker to Distinguish Steroid-Resistant from Steroid-Sensitive Idiopathic Nephrotic Syndrome in Iraqi Children. Siriraj Medical Journal 2023;75:248-58.

https://doi.org/10.33192/smj.v75i4.260831

Waheed AA, Pedraza F, Lenz O, Isakova T. Phosphate control in end-stage renal disease: Barriers and opportunities. Nephrology Dialysis Transplantation 2013;28:2961-8.

https://doi.org/10.1093/ndt/gft244

Tajbakhsh R, Joshaghani HR, Bayzayi F, Haddad M, Qorbani M. Association between pruritus and serum concentrations of parathormone, calcium and phosphorus in hemodialysis patients. Saudi Journal of Kidney Diseases and Transplantation : An Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia 2013;24:702-6.

https://doi.org/10.4103/1319-2442.113858

Zhao JH, Zhu QS, Li YW, Wang LL. Determinants of the intensity of uremic pruritus in patients receiving maintenance hemodialysis: A cross-sectional study. PLoS ONE 2021;16:1-

https://doi.org/10.1371/journal.pone.0245370

Shetty D, Nayak AM, Datta D, et al. Uremic pruritus: prevalence, determinants, and its impact on health-related quality of life and sleep in Indian patients undergoing hemodialysis. Irish Journal of Medical Science 2023:3109 15.

https://doi.org/10.1007/s11845-023-03393-8

Satti MZ, Arshad D, Javed H, et al. Uremic Pruritus: Prevalence and Impact on Quality of Life and Depressive Symptoms in Hemodialysis Patients. Cureus 2019;11:3-9.

https://doi.org/10.7759/cureus.5178

Hu T, Wang B, Liao X, Wang S. Clinical features and risk factors of pruritus in patients with chronic renal failure. Experimental and Therapeutic Medicine 2019:964-71.

https://doi.org/10.3892/etm.2019.7588

Einollahi B, Motalebi M, Izadianmehr N. Re: Relationship between serum intact parathyroid hormone and pruritus in hemodialysis patients. Iranian Journal of Kidney Diseases 2014;8:257-8.

URL

Kathem SH, Mohieldin AM, Abdul-Majeed S, et al. Ciliotherapy: A novel intervention in polycystic kidney disease. Journal of Geriatric Cardiology 2014;11:63-73.

https://doi.org/10.3969%2Fj.issn.1671-5411.2014.01.001

Bağci IS, Ruzicka T. IL-31: A new key player in dermatology and beyond. Journal of Allergy and Clinical Immunology 2018;141:858-66.

https://doi.org/10.1016/j.jaci.2017.10.045

Nobbe S, Dziunycz P, Mühleisen B, et al. IL-31 expression by inflammatory cells is preferentially elevated in atopic dermatitis. Acta Dermato-Venereologica 2012;92:24-8.

https://doi.org/10.2340/00015555-1191

Datsi A, Steinhoff M, Ahmad F, Alam M, Buddenkotte J. Interleukin-31: The "itchy" cytokine in inflammation and therapy. Allergy: European Journal of Allergy and Clinical Immunology 2021;76:2982-97.

https://doi.org/10.1111/all.14791

Saleem MD, Oussedik E, D'Amber V, Feldman SR. Interleukin-31 pathway and its role in atopic dermatitis: a systematic review. Journal of Dermatological Treatment 2017;28:591-9.

https://doi.org/10.1080/09546634.2017.1290205

Toyama S, Tominaga M, Takamori K. Connections between immune-derived mediators and sensory nerves for itch sensation. International Journal of Molecular Sciences 2021;22.

https://doi.org/10.3390/ijms222212365

Alhassan AR. Study of serum level of interleukin 31 in patients with uremic pruritus. Menoufia Medical Journal 2022;35:190-5. https://doi.org/10.4103/mmj.mmj

Ardinata D, Zain-Hamid R, Roesyanto-Mahadi ID, Mihardja H. Interleukin-31 serum and pruritus dimension after acupuncture treatment in hemodialysis patients: A randomized clinical trial. Open Access Macedonian Journal of Medical Sciences 2021;9:196-201

https://doi.org/10.3889/oamjms.2021.5599

Rodríguez M, Rodríguez-Ortiz ME. Recent advances in understanding and managing secondary hyperparathyroidism in chronic kidney disease. F1000Research 2020;9.

https://doi.org/10.12688/f1000research.22636.1

Levy AR, Xing S, Brunelli SM, et al. Symptoms of Secondary Hyperparathyroidism in Patients Receiving Maintenance Hemodialysis: A Prospective Cohort Study. American Journal of Kidney Diseases 2020;75:373-83.

https://doi.org/10.1053/j.ajkd.2019.07.013

Chronic kidney disease; Hemodialysis; Itching; InterlukinL-31;Uremic Pruritus.

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Published

01.10.2024

How to Cite

1.
Abdulqahar MS, A. Kasem A. Evaluation of Interleukin-31 Serum Levels in Patients with Chronic Kidney Disease on Hemodialysis with and without Uremic Pruritus. J Fac Med Baghdad [Internet]. 2024 Oct. 1 [cited 2024 Nov. 11];66(3):350-6. Available from: https://iqjmc.uobaghdad.edu.iq/index.php/19JFacMedBaghdad36/article/view/2329

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