# Energy-adjusted dietary inflammatory index is associated with chronic kidney disease-associated pruritus in Hemodialysis patients: a cross-sectional study

## TL;DR

This study found that a pro-inflammatory diet is linked to a higher risk and severity of itching in hemodialysis patients with chronic kidney disease.

## Contribution

The study is the first to link the Energy-adjusted Dietary Inflammatory Index (E-DII) with chronic kidney disease-associated pruritus in hemodialysis patients.

## Key findings

- Higher E-DII scores were associated with increased risk of CKD-aP across three models.
- E-DII scores showed significant associations with both CKD-aP and VAS scores.
- The findings suggest that dietary inflammation may influence pruritus severity in HD patients.

## Abstract

Chronic kidney disease-associated pruritus (CKD-aP) is a common and bothersome symptom among hemodialysis (HD) patients. This study aimed to determine the association of Energy-adjusted dietary inflammatory index (E-DII) index with the risk and severity of CKD-aP in hemodialysis patients.

This cross-sectional study was conducted on 200 HD patients. A valid 168-item semi-quantitative Food Frequency Questionnaire (FFQ) was used to assess the usual food intake and calculated E-DII. Yosipovitch Itch Questionnaire was used to assess CKD-aP. Based on the E- DII score, odds ratios, and 95% confidence intervals were calculated for the risk of CKD-aP. Generalized linear models (GLM) was used to determine the association between E-DII scores and CKD-aP score, and pruritus Visual Analogue Scale (VAS) score.

The continuous E-DII score was associated with an increased risk of CKD-aP in all three models: model 1, OR = 1.19 (95% CI: 1.02–1.40); model 2, OR = 1.29 (1.01–1.65); and model 3, OR = 1.41 (1.01–1.98). Moreover, linear regression analysis showed statistically significant associations (P < .05) between the E-DII score and both CKD-aP and VAS scores across all three models.

This study provides evidence that higher consumption of a pro-inflammatory diet is associated with an increased risk of CKD-aP in HD patients. Future studies with prospective and interventional designs are required to clarify the association between this dietary index and CKD-aP in HD patients.