Translation and applicability of an Italian version of the Uremic Pruritus in Dialysis Patients (UP-Dial) questionnaire

Introduction: The Uremic Pruritus in Dialysis Patients (UP-DIAL)—14-item scale is a validated, multidimensional tool for assessing pruritus severity and clinical burden among patients with chronic kidney disease-associated pruritus (CKD-aP). While the scale has been developed in Thai and other non-Thai languages, an Italian version and cross-cultural adaptation have not been established for Italian-speaking CKD-aP populations. Aims: This study aimed to translate and validate an Italian version of the UP-Dial—14-item questionnaire for use among hemodialysis (HD) patients. Materials and Methods: Following international guidelines, a rigorous translation process was undertaken, including independent forward and backward translations to ensure linguistic and conceptual equivalence. The validation cohort comprised HD patients with CKD-aP from seven centers across Calabria, Italy. Patients and healthcare professionals reviewed the Italian version to evaluate usability, readability, and cultural adaptation. Internal consistency was assessed using Cronbach’s alpha, and test-retest reliability was evaluated with the intraclass correlation coefficient (ICC) over a 7-day interval. Results: Of 323 HD patients screened, 132 with CKD-aP were included. Both patients and professionals confirmed satisfactory face validity and adaptation. The Italian UP-DIAL—14-item demonstrated excellent internal consistency (Cronbach’s α = 0.91; 95% CI: 0.89-0.93) and reproducibility (ICC = 0.92; 95% CI: 0.90-0.94). Conclusions: The Italian version of the UP-DIAL—14-item is a valid, reliable, and reproducible instrument for assessing CKD-aP in HD patients. It is suitable as a patient-reported outcome measure for both clinical practice and research.