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Effectiveness and safety profiling of zolpidem and acupressure in CKD associated pruritus: An interventional study

Rehman IU 1 , Ahmed R 2 , Rahman AU 3 , Wu DBC 1 , Munib S 2 , Shah Y 4 Show all authors , Khan NA 5 , Rehman AU 6 , Lee LH 7 , Chan KG 8 , Khan TM 1

Affiliations 

  • 1 School of Pharmacy, Monash University, Jalan Lagoon Selatan, Bandar Sunway, Selangor Darul Ehsan, Malaysia
  • 2 Department of Nephrology, Institute of Kidney Diseases, Peshawar
  • 3 Department of Urology
  • 4 Department of Pharmacy, Abdul Wali Khan University, Mardan, Khyber Pukhtoonkhwa
  • 5 Department of Nephrology, North West General Hospital and Research Center, Peshawar
  • 6 Biomedical Engineering Technology, Foundation University Islamabad, Pakistan
  • 7 Novel Bacteria and Drug Discovery (NBDD) Research Group, Microbiome and Bioresource Research Strength, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway 47500, Selangor Darul Ehsan, Malaysia
  • 8 International Genome Centre, Jiangsu University, Zhenjiang, China
Medicine (Baltimore), 2021 May 28;100(21):e25995.
PMID: 34032717 DOI: 10.1097/MD.0000000000025995

Abstract

BACKGROUND: Chronic kidney disease (CKD)-associated pruritus (CKD-aP) contributes to poor quality of life, including reduced sleep quality and poor sleep quality is a source of patient stress and is linked to lower health-related quality of life. This study aimed to investigate the effectiveness of zolpidem 10 mg and acupressure therapy on foot acupoints to improve the sleep quality and overall quality of life among hemodialysis patients suffering from CKD-aP.

METHOD: A multicenter, prospective, randomized, parallel-design, open label interventional study to estimate the effectiveness of zolpidem (10 mg) oral tablets versus acupressure on sleep quality and quality of life in patients with CKD-aP on hemodialysis. A total of 58 hemodialysis patients having sleep disturbance due to CKD-aP completed the entire 8-week follow-up. The patients were divided into a control (acupressure) group of 28 patients and an intervention (zolpidem) group of 30 patients.

RESULTS: A total of 58 patients having CKD-aP and sleep disturbance were recruited. In the control group there was a reduction in the PSQI score with a mean ± SD from 12.28 ± 3.59 to 9.25 ± 3.99, while in the intervention group the reduction in PSQI score with a mean ± SD was from 14.73 ± 4.14 to 10.03 ± 4.04 from baseline to endpoint. However, the EQ5D index score and EQ-visual analogue scale (VAS) at baseline for the control group with a mean ± SD was 0.49 ± 0.30 and 50.17 ± 8.65, respectively, while for the intervention group the values were 0.62 ± 0.26 and 47.17 ± 5.82, respectively. The mean EQ5D index score in the control group improved from 0.49 ± 0.30 to 0.53 ± 0.30, but in the intervention group there was no statistical improvement in mean EQ5D index score from 0.62 ± 0.26 to 0.62 ± 0.27 from baseline to week 8. The EQ 5D improved in both groups and the EQ-VAS score was 2.67 points higher at week 8 as compared to baseline in the control group, while in the intervention group the score was 3.33 points higher at week 8 as compared to baseline. Comparing with baseline, the PSQI scores were significantly reduced after week 4 and week 8 (P =  

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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