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The Relationship Between Serum Interleukin-31 Levels and Chronic Kidney Disease-Associated Pruritus in Patients Undergoing Hemodialysis

ACTA MEDICA INDONESIANA · Vol. 58 No. 3 (2026)

ISSN
2338-2732, 0125-9326
Published
2026-09-28
Publisher
The Indonesian Society of Internal Medicine
Language
eng
License
creativecommons.org/licenses/by/4.0

Abstract

Background: Chronic kidney disease-associated pruritus (CKD-aP) has been linked to immune dysregulation, including elevated interleukin-31 (IL-31) levels. However, the limited research on serum IL-31 levels in patients with CKD-aP has yielded inconsistent findings due to heterogeneous patient populations and varied assessment methods. This study elucidated the relationship between serum IL-31 levels, CKD-aP, and its severity in patients undergoing routine hemodialysis (HD). Methods: This cross-sectional observational study included patients undergoing HD at Dr. Cipto Mangunkusumo Hospital between April and May 2024. Pruritus was assessed using the visual analog scale (VAS) and 5-D itch scale. Serum IL-31 levels were measured using enzyme-linked immunosorbent assay. Bivariate and multivariate analyses were performed. Results: Among 70 participants (54.3% male; median age, 52.5 years; median HD vintage, 57 months), 35 experienced CKD-aP. The median VAS and 5-D itch scale scores were 5.3 and 13, respectively, indicating moderate itching severity. Patients with CKD-aP had significantly higher serum IL-31 levels than those without CKD-aP (p = 0.05). Receiver operating characteristic analysis showed modest discriminatory ability (area under the curve = 0.64), with a sensitivity of 51.4% and specificity of 74.3% at a cut-off of 173 pg/mL. A significant association was observed between serum IL-31 levels and CKD-aP (p = 0.03). However, no significant correlation was found between IL-31 levels and pruritus severity as measured by the VAS (p = 0.79) or 5-D itch scale (p = 0.44). Conclusion: Serum IL-31 levels were higher in patients with CKD-aP, suggesting its potential association with pruritus. However, its modest diagnostic performance and lack of correlation with itch severity indicate that IL-31 is unlikely to serve as a standalone clinical biomarker and may have a limited role as an adjunctive or exploratory marker.

Keywords

Collaboration network of the authors

40 authors · 319 co-authorship links · showing the 40 most connected

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  • University of Indonesia
  • Affiliation unknown
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Co-authorOrganisationJoint articles
Rudi PutrantoAffiliation unknown31
Ikhwan RinaldiAffiliation unknown16
Cleopas Martin RumendeAffiliation unknown11
Siti SetiatiAffiliation unknown11
Edward FaisalAffiliation unknown10
Em YunirUniversity of Indonesia10
Murdani AbdullahAffiliation unknown9
Anshari Saifuddin HasibuanAffiliation unknown9
Sukamto KoesnoeAffiliation unknown9
Kuntjoro HarimurtiAffiliation unknown9
Iris RengganisAffiliation unknown8
Dyah PurnamasariAffiliation unknown8
Eka GinanjarAffiliation unknown8
Suzy MariaAffiliation unknown7
Idrus AlwiAffiliation unknown7
Evy YunihastutiAffiliation unknown6
Dina ElitaAffiliation unknown6
Chyntia Olivia Maurine JasirwanAffiliation unknown6
Sally Aman NasutionAffiliation unknown6
Teguh Harjono KarjadiAffiliation unknown5
Dadang MakmunAffiliation unknown4
Cosphiadi IrawanAffiliation unknown4
Dono AntonoAffiliation unknown4
Pradana SoewondoAffiliation unknown4
Suhendro SuwartoAffiliation unknown4
Leonard NainggolanAffiliation unknown4
Dante Saksono HarbuwonoAffiliation unknown3
Samsuridjal DjauziAffiliation unknown3
Raden Irawati IsmailAffiliation unknown3
Wismandari WisnuAffiliation unknown3
Aida LydiaAffiliation unknown3
Ni Made HustriniAffiliation unknown3

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, first harvested 8 Nov 2026, last seen 8 Nov 2026.
Original metadata (oai_dc) 
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	<dc:title xml:lang="en-US">The Relationship Between Serum Interleukin-31 Levels and Chronic Kidney Disease-Associated Pruritus in Patients Undergoing Hemodialysis</dc:title>
	<dc:creator>Asmara, I Gede Yasa</dc:creator>
	<dc:creator>Legiawati, Lili</dc:creator>
	<dc:creator>Widhani, Alvina</dc:creator>
	<dc:creator>Nugroho, Pringgodigdo</dc:creator>
	<dc:creator>Mansjoer, Arif</dc:creator>
	<dc:creator>Shatri, Hamzah</dc:creator>
	<dc:creator>Subekti, Imam</dc:creator>
	<dc:creator>Marbun, Maruhum Bonar Hasiholan</dc:creator>
	<dc:subject xml:lang="en-US">Hemodialysis</dc:subject>
	<dc:subject xml:lang="en-US">Interleukin-31</dc:subject>
	<dc:subject xml:lang="en-US">5-D itch scale</dc:subject>
	<dc:subject xml:lang="en-US">visual analog scale (VAS) </dc:subject>
	<dc:subject xml:lang="en-US">Chronic kidney disease-associated pruritus (CKD-aP)</dc:subject>
	<dc:description xml:lang="en-US">Background: Chronic kidney disease-associated pruritus (CKD-aP) has been linked to immune dysregulation, including elevated interleukin-31 (IL-31) levels. However, the limited research on serum IL-31 levels in patients with CKD-aP has yielded inconsistent findings due to heterogeneous patient populations and varied assessment methods. This study elucidated the relationship between serum IL-31 levels, CKD-aP, and its severity in patients undergoing routine hemodialysis (HD). Methods: This cross-sectional observational study included patients undergoing HD at Dr. Cipto Mangunkusumo Hospital between April and May 2024. Pruritus was assessed using the visual analog scale (VAS) and 5-D itch scale. Serum IL-31 levels were measured using enzyme-linked immunosorbent assay. Bivariate and multivariate analyses were performed. Results: Among 70 participants (54.3% male; median age, 52.5 years; median HD vintage, 57 months), 35 experienced CKD-aP. The median VAS and 5-D itch scale scores were 5.3 and 13, respectively, indicating moderate itching severity. Patients with CKD-aP had significantly higher serum IL-31 levels than those without CKD-aP (p = 0.05). Receiver operating characteristic analysis showed modest discriminatory ability (area under the curve = 0.64), with a sensitivity of 51.4% and specificity of 74.3% at a cut-off of 173 pg/mL. A significant association was observed between serum IL-31 levels and CKD-aP (p = 0.03). However, no significant correlation was found between IL-31 levels and pruritus severity as measured by the VAS (p = 0.79) or 5-D itch scale (p = 0.44). Conclusion: Serum IL-31 levels were higher in patients with CKD-aP, suggesting its potential association with pruritus. However, its modest diagnostic performance and lack of correlation with itch severity indicate that IL-31 is unlikely to serve as a standalone clinical biomarker and may have a limited role as an adjunctive or exploratory marker.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2026-09-28</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/2943</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 58 No. 3 (2026): Acta Medica Indonesiana; 344</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/2943/883</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2026 Acta Medica Indonesiana</dc:rights>
	<dc:rights xml:lang="en-US">https://creativecommons.org/licenses/by/4.0</dc:rights>
</oai_dc:dc>