Hubungan Kadar Substansi P dan Hidrasi Kulit dengan Derajat Pruritus pada Pasien Penyakit Ginjal Kronis yang Menjalani Hemodialisis

Abstract

Background: Pruritus is one of the most distressing symptoms experienced by patients with chronic kidney disease (CKD) undergoing hemodialysis. Although its pathogenesis is multifactorial, neurogenic mediators such as Substance P (SP) and impaired skin hydration are believed to contribute significantly to itch development. However, only limited studies have concurrently evaluated SP levels and objective skin hydration in relation to pruritus severity in CKD patients. Objective: To analyze the association between serum SP levels and skin hydration with pruritus severity in patients with CKD undergoing hemodialysis. Methods: This analytical cross-sectional study involved 72 CKD patients undergoing hemodialysis at Prof. Dr. Chairuddin Panusunan Lubis Hospital, Universitas Sumatera Utara, and H. Adam Malik General Hospital, Medan. Pruritus severity was assessed using the UP-Dial questionnaire. Serum Substance P levels were measured using the ELISA method, and skin hydration was assessed on the extensor forearm using the Corneometer® CM 825. Data were analyzed using Spearman’s correlation. Results: The majority of subjects were male (52.8%) with the highest age groups being 46–55 years and 56–65 years (30.6% each). The most common clinical finding was xerosis (94.4%). The mean Substance P level was 680.97 ± 124.38 pg/ml. Most subjects (87.5%) had severely dry skin, and the most frequently reported pruritus severity was mild (41.7%). There was a strong positive correlation between Substance P levels and pruritus severity (p=0.000; p<0.05) (r = 0,686), and a moderate negative correlation was found between skin hydration and pruritus severity in patients with chronic kidney disease undergoing hemodialysis (p=0.026; p<0.05) (r = -0,470). Conclusion: There is a strong positive correlation between Substance P levels and pruritus severity, and a moderate negative correlation between skin hydration and pruritus severity in chronic kidney disease patients undergoing hemodialysis.