A Study On The Correlation Between Interleukin-31 And Hemodialysis Skin Itching

Objective:This project analyzes the correlation between serum interleukin-31 levels and uremic pruritus in maintenance hemodialysis patients,which is used to guide the clinical management of uremia pruritus patients.Methods:According to the criteria of the exclusion,70 patients with maintenance hemodialysis were selected,including 35 in the itching group and 35 in the non-pruritus group,and the information of the patients was collected,including:age,gender,dialysis mode,blood calcium,blood phosphorus,calcium-phosphorus product,blood creatinine,blood urea nitrogen,alkaline phosphatase,parathyroid hormone,β2-microglobulin,and serum interleukin-31 was detected by ELISA method.SPSS 25.0 statistical software was used for analysis,and the mean±standard deviation was used for the data that met the normality test,and the significance comparison between the two groups was measured by two independent samples t-test.The data for the nonnormality test were expressed in the form of quartile P50(P25,P75),and the significance comparison between the two groups was using the Mann-Whitney test.Theχ~2test was used for the comparison of significance between the two groups.The correlation coefficient of Spearman was used to analyze the correlation between age,blood calcium,blood phosphorus,calcium-phosphorus product,blood creatinine,blood urea nitrogen,alkaline phosphatase,parathyroid hormone,β2-microglobulin,interleukin-31 and uremia pruritus,and finally multiple linear regression analysis was performed on the influencing factors of uremia pruritus.Whether different dialysis methods affected the degree of uremia itching was analyzed byχ2 test.The difference was statistically significant at P<0.05.Results:1.In this study a total of 70 maintenance hemodialysis patients were included,including 35 in the pruritus group and 35 in the non-pruritus group.The comparison results of clinical data between the two groups are shown in Table 1 and Figure 1:there was no significant difference in age,sex,blood calcium,blood phosphorus,calcium-phosphorus product,blood creatinine,blood urea nitrogen,alkaline phosphatase,parathyroid hormone,andβ2-microglobulin between the pruritus group and non-pruritus group.Compared with the non-pruritus group,the level of interleukin-31 in the pruritus group was significantly increased[97.71(75.06,133.94)vs 123.40(97.68,142.64),P=0.039<0.05],and the difference was statistically significant.2.Spearman rank was used to test the correlation between various clinical indexes and uremic pruritus(all samples),and Table 2 showed that there was no correlation between age,blood calcium,blood phosphorus,calcium-phosphorus product,blood creatinine,blood urea nitrogen,alkaline phosphatase,parathyroid hormone,β2-microglobulin and pruritus score(P>0.05);there was a positive correlation between interleukin-31 and pruritus score(r=0.268,P=0.025<0.05).3.Multiple linear regression was used to analyze the risk factors of pruritus,and the results were shown in Table 3,indicating that creatinine(P=0.040<0.05)and sex(P=0.009<0.05)were risk factors affecting uremia pruritus.The results did not find that IL-31 was a risk factor affecting uremia pruritus,and it could not be ruled out that IL-31had a nonlinear relationship with uremia pruritus.4.Only 28 patients received hemodialysis(HD)(Group A),23 patients received hemodialysis combined with hemofiltration(HD+HF)or hemodialysis combined with hemodialysis(HD+HDF)(Group B),9 patients received hemodialysis combined with hemoperfusion(HD+HP)(Group C),and 10 patients received more than three dialysis methods(Group D).The fisher precision chi-square test was used to analyze whether different dialysis methods had an effect on uremia pruritus.Table 4 describes the proportion of people with itching symptoms and the proportion of people without itching symptoms under different dialysis methods,and the results show that there are obvious differences in the proportion of pruritus under different dialysis methods(χ2=11.996,P=0.007<0.05).Further comparison between the two pairs showed that there was a significant difference in the proportion of people with itching symptoms between dialysis A and B(P<0.05),that is,the number of people receiving HD+HF or HD+HDF was significantly lower than that receiving HD alone,while there was no significant difference in the number of itching between other dialysis methods(P>0.05).Conclusion:1.Interleukin-31 was significantly elevated in patients with uremic pruritus,and there was a positive correlation between uremic pruritus and interleukin-31.2.Serum creatinine and sex are risk factors affecting uremia itching.3.Compared with patients with simple hemodialysis,receiving hemofiltration or hemodialysis filtration can effectively reduce the symptoms of uremia itching.