Mitigating Uremic Pruritus and Improving Family Coping in Stage 5 Chronic Kidney Disease: A Dual-Intervention Case Study Using Topical Petrolatum
Case Study on Family Coping Support in Nursing
DOI:
https://doi.org/10.53713/htechj.v4i3.732Keywords:
caregiver support, chronic kidney disease, family coping, petroleum jelly, uremic pruritusAbstract
Chronic Kidney Disease (CKD) imposes severe physical and psychosocial burdens, frequently precipitating a measurable decline in family coping mechanisms. This study explores the clinical efficacy of a dual intervention combining structured family coping support and topical petroleum jelly therapy for managing uremic pruritus and caregiver strain. Employing a descriptive case study design, researchers intervened with the family of a 55-year-old male diagnosed with stage 5 CKD who presented with severe pruritus, xerosis, and skin discoloration. The family initially exhibited care neglect, limited communication, and inadequate health literacy regarding appropriate symptom management. The protocol entailed targeted coping support education, along with twice-daily petroleum jelly application over eight consecutive days. Outcome measurements utilized the validated 5D Pruritus Scale and standardized nursing criteria to evaluate family coping. Post-intervention data revealed a significant reduction in the 5D Pruritus Scale score from 10 to 6, indicating a clear transition to mild pruritus. Family assessments concurrently demonstrated substantial improvements in health knowledge, active caregiving engagement, and interpersonal communication, effectively eliminating previous neglectful behaviors. These findings establish that integrating low-cost topical emollient therapy with targeted psychosocial education constitutes a highly effective, holistic nursing strategy. This comprehensive approach successfully mitigates dermatological distress while simultaneously restoring family coping capacity, offering a highly replicable model for advanced CKD management in community health settings.
References
Ahmed, K., Dubey, M. K., Dubey, S., & Pandey, D. K. (2025). Chronic kidney disease: Causes, treatment, management, and future scope. In Computational intelligence for genomics data (pp. 99–111). Academic Press. https://doi.org/10.1016/B978-0-443-30080-6.00010-9
Ania-González, N., Martín-Martín, J., Amezqueta-Goñi, P., & Vázquez-Calatayud, M. (2022). The needs of families who care for individuals with kidney failure on comprehensive conservative care: A qualitative systematic review. Journal of Renal Care, 48(4), 230–242. https://doi.org/10.1111/jorc.12415
Araújo, H., Marques, E., Lourenço, I., Bonifácio, C., & Gomes, F. (2026). Nursing interventions to support family caregivers of patients on haemodialysis: A mixed-methods systematic review. Journal of Advanced Nursing, 82(6), 5813–5834. https://doi.org/10.1111/jan.70297
Bañez, J. (2026). Divulging the lived experiences that honed the psychosocial well-being of individuals receiving hemodialysis treatment. Aloysian Interdisciplinary Journal of Social Sciences, Education, and Allied Fields, 2(4), 573–600. https://doi.org/10.5281/zenodo.19857459
Chu, S. Y., Ibrahim, N., Amit, N., Abdul Gafor, A. H., Ismail, R., Lee, K. W., & Siau, C. S. (2023). Interventions to reduce caregiver burden among caregivers of chronic kidney disease (CKD) patients: A scoping review. SAGE Open, 13(2). https://doi.org/10.1177/21582440231178703
Davison, S. N., Pommer, W., Brown, M. A., Douglas, C. A., Gelfand, S. L., Gueco, I. P., Hole, B. D., Homma, S., Kazancıoğlu, R. T., Kitamura, H., Koubar, S. H., Krause, R., Li, K. C., Lowney, A. C., Nagaraju, S. P., Niang, A., Obrador, G. T., Ohtake, Y., Schell, J. O., ... Brennan, F. P. (2023). Conservative kidney management and kidney supportive care: Core components of integrated care for people with kidney failure. Kidney International, 105(1), 35–45. https://doi.org/10.1016/j.kint.2023.10.001
Faldu, C. T., & Knicely, D. H. (2025). Advanced chronic kidney disease and patient education. Kidney and Dialysis, 5(3), 32. https://doi.org/10.3390/kidneydial5030032
Fluhr, J. W., Muguet, V., & Christen-Zaech, S. (2025). Restoring skin hydration and barrier function: Mechanistic insights into basic emollients for xerosis cutis. International Journal of Dermatology, 64, 5–12. https://doi.org/10.1111/ijd.17790
Francis, A., Harhay, M. N., Ong, A. C., Tummalapalli, S. L., Ortiz, A., Fogo, A. B., ... International Society of Nephrology. (2024). Chronic kidney disease and the global public health agenda: An international consensus. Nature Reviews Nephrology, 20(7), 473–485. https://doi.org/10.1038/s41581-024-00820-6
Frandsen, C. E., Dieperink, H., Trettin, B., & Agerskov, H. (2023). Advance care planning to patients with chronic kidney disease and their families: An intervention development study. Journal of Clinical Nursing, 32(23–24), 8104–8115. https://doi.org/10.1111/jocn.16875
Jha, C. M., Dastoor, H. D., Gopalakrishnan, N., & Holt, S. G. (2022). Obstacles to early diagnosis and treatment of pruritus in patients with chronic kidney disease: Current perspectives. International Journal of Nephrology and Renovascular Disease, 15, 335–352. https://doi.org/10.2147/IJNRD.S294147
Jiakponna, E. C., Agbomola, J. O., Ipede, O., Karakitie, L., Ogunsina, A. J., Adebayo, K. T., & Tinuoye, M. O. (2024). Psychosocial factors in chronic disease management: Implications for health psychology. International Journal of Science and Research Archive, 12(2), 117–128. https://doi.org/10.30574/ijsra.2024.12.2.1219
Kljajić, M., Parać, E., Atić, A., & Bašić-Jukić, N. (2025). Uremic pruritus in hemodialysis: Mechanisms, burden, and emerging therapies. Journal of Clinical Medicine, 15(2), 494. https://doi.org/10.3390/jcm15020494
Menzaghi, F., Vernon, M. K., Mattera, M., Cirulli, J., Wen, W., Spencer, R. H., & Munera, C. (2023). The burden of pruritus associated with CKD: A mixed methods analysis among patients undergoing dialysis. Kidney Medicine, 5(9), 100696. https://doi.org/10.1016/j.xkme.2023.100696
Muhaxheri, G., Kelmendi, J., Cakolli, V. H., & Kolgeci, D. (2023). Oral changes in chronic renal failure patients in one of the regional hospitals in Kosovo. International Journal of Biomedicine, 13(4), 306–311. https://doi.org/10.21103/Article13(4)_OA12
Nadya, A., Asniar, A., & Febriana, D. (2025). An overview of family management in the care of children with cancer. Nursing and Health Sciences Journal (NHSJ), 5(3), 356–363. https://doi.org/10.53713/nhsj.v5i3.541
Polner, K., Sallay, E., Detrich, K., & Haris, Á. (2022). Multidisciplinary education and lifestyle camps for CKD patients and their closest family members: Effects on disease progression, self-management and psychosocial condition—A retrospective cohort study. International Urology and Nephrology, 54(4), 851–860. https://doi.org/10.1007/s11255-021-02948-x
Rao, H., Guo, Y., Qiu, L., & Ren, X. (2025). Exploring health challenges and coping strategies in young patients undergoing maintenance hemodialysis: A qualitative study. BMC Nephrology, 26(1), 378. https://doi.org/10.1186/s12882-025-04320-y
Romagnani, P., Agarwal, R., Chan, J. C., Levin, A., Kalyesubula, R., Karam, S., ... Anders, H. J. (2025). Chronic kidney disease. Nature Reviews Disease Primers, 11(1), 8. https://doi.org/10.1038/s41572-024-00589-9
Roy, Y. R., Ficheux, A. S., Misery, L., & Brenaut, E. (2022). Efficacy of topical and systemic treatments for atopic dermatitis on pruritus: A systematic literature review and meta-analysis. Frontiers in Medicine, 9, 1079323. https://doi.org/10.3389/fmed.2022.1079323
Shaabna, Z., Abdalrahim, M. S., & Zeilani, R. (2025). Experiences and needs of family caregivers for patients with end-stage renal disease (ESRD) in Palestine. BMC Palliative Care, 24(1), 81. https://doi.org/10.1186/s12904-025-01722-5
Sitorus, F. E., Meliala, A. S., Hariati, H., Siahaan, J. M., Girsang, R., Purba, B. B., ... Tampubolon, E. (2026). The impact of a structured physical exercise program on physical function and quality of life among patients with chronic kidney disease undergoing hemodialysis. Nursing and Health Sciences Journal (NHSJ), 6(2), 230–240. https://doi.org/10.53713/nhsj.v6i2.677
Sousa, H., Ribeiro, O., Christensen, A. J., & Figueiredo, D. (2023). Designing family-based interventions in kidney failure: The perspectives of the triad “patients on haemodialysis/family caregivers/healthcare professionals.” British Journal of Health Psychology, 28(3), 672–689. https://doi.org/10.1111/bjhp.12647
Verma, V., Lamture, Y., & Ankar, R. (2023). Management of uremic xerosis and chronic kidney disease-associated pruritus (CKD-aP) with topical preparations: A systematic review and implications in the Indian context. Cureus, 15(7), e42587. https://doi.org/10.7759/cureus.42587
Wang, C. C. Y., Wu, H. H. L., Ponnusamy, A., Pye, I., & Woywodt, A. (2022). Pruritus in chronic kidney disease: An update. Allergies, 2(3), 87–105. https://doi.org/10.3390/allergies2030009
Wee, L. X., Tan, P. S. T., & Chen, H. (2022). Experiences and needs of families caring for children and adolescents with chronic kidney disease: A meta-synthesis. Journal of Pediatric Nursing, 63, 52–63. https://doi.org/10.1016/j.pedn.2021.12.028
Yusuf, A., Purba, J. M., Putri, D. E., Aditya, R. S., Alruwaili, A. S., & AlRazeeni, D. M. (2024). Family-centered care experiences in elderly with chronic diseases in communities: Qualitative study of patients, families, nurses, and volunteers. Health Equity. https://doi.org/10.1089/heq.2024.0009
Zeng, F., Zhu, C., Ding, L., Yang, B., & Liu, N. (2026). Chronic kidney disease-associated pruritus: A perspective on skin barrier damage. Renal Failure, 48(1). https://doi.org/10.1080/0886022X.2026.2635299












