Transformation of 5-D itch scale and numerical rating scale in chronic hemodialysis patients

Jia Wen Lai, Hung Chih Chen, Che Yi Chou, Hung Rong Yen, Tsai Chung Li, Mao Feng Sun, Hen Hong Chang, Chiu Ching Huang, Fuu Jen Tsai, Johannes Tschen, Chiz Tzung Chang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

36 Scopus citations


Background: Pruritus is a common and frustrating symptom in hemodialysis (HD) patients and 5-D itch scale is proposed as a reliable measurement of pruritus. However, information regarding 5-D itch scale categories is currently unavailable. We explored optimal cut-offs 5-D itching scale based on numerical rating scale (NRS) categories in HD patients. Methods: Four hundred and nine HD patients in China Medical University Hospital in December 2014 were included and severity of pruritus was estimated using NRS and 5-D itch scale. The association of NRS and 5-D itch scale was analyzed by linear regression. The optimal cut-offs for 5-D itch scale based on NRS categories were generated. Results: The average NRS was 3.4 ± 3.0 and the average 5-D itch scale was 10.9 ± 4.8. The 5-D score was strongly correlated with the NRS: r = 0.831 (p < 0.001). NRS = −2.31 + 0.52 × (5-D scale). The averages of 5-D scales were 6.4 ± 1.5, 9.6 ± 2.2, 13.1 ± 3.2, 15.7 ± 4.4, 19.5 ± 4.4 for no, mild, moderate, severe, and very severe pruritus based on categorized NRS. A 5-D itch scale categories were proposed, ≤ 8 for NRS = 0, 9-11 for mild pruritus, 12-17 for moderate pruritus, 18-21 for severe pruritus and ≥ 22 for very severe pruritus. Conclusions: Categories for the 5-D itch scale were proposed based on the measurements of pruritus severity in HD patients. This information provides a simple solution that enables transformation between the 5-D itch scale and the numerical rating scale.

Original languageEnglish
Article number56
JournalBMC Nephrology
Issue number1
StatePublished - 08 02 2017
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2017 The Author(s).


  • 5-D itch scale
  • Hemodialysis
  • Numerical rating scale
  • Pruritus


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