Effect of Skin Care With an Emollient Containing a High Water Content on Mild Uremic Pruritus

Abstract:  Skin care is very important for preventing uremic pruritus. However, mild uremic pruritus has usually been treated with antihistamine and urea‐containing ointments. We therefore examined the effects of an aqueous gel with higher water content. Twenty hemodialysis patients with mild pruritus who were not being treated with any emollient were divided into two groups of 10 each. Patients in one group were treated with an aqueous gel containing 80% water. This emollient was applied twice daily for 2 weeks. No emollient was applied for the next 2 weeks. The other group of patients were not treated with any emollient for the 4 weeks. Visual analog scale scores for itching in the experimental group at week 2 were significantly decreased compared with that at week 0 (3.5 ± 0.3 vs 0.6 ± 0.2, P < 0.01). Skin dryness in the experimental group was significantly improved at week 2 compared with that at week 0. The visual analog scale score for itching increased to 1.2 ± 0.5 and skin dryness reappeared in 40% of patients by week 4, i.e. after the emollient was stopped. There were no significant changes in the control group during the study. It is concluded that the aqueous gel with high water content reduced itching and improved xerosis in patients with mild uremic pruritus. It is reasonable that skin care with an emollient containing a high water content is first started for hemodialysis patients with xerosis, even if  they  do  not feel itching. 

[1]  A. Carmichael,et al.  A randomized, placebo‐controlled, double‐blind trial of ondansetron in renal itch , 2003, The British journal of dermatology.

[2]  H. Yeom,et al.  The effects of aromatherapy on pruritus in patients undergoing hemodialysis. , 2002, Dermatology nursing.

[3]  A. Hishida,et al.  Pruritus and Hydration State of Stratum corneum in Hemodialysis Patients , 2000, American Journal of Nephrology.

[4]  M. Okada,et al.  Psychological effects of aromatherapy on chronic hemodialysis patients , 2000, Psychiatry and clinical neurosciences.

[5]  S. Crawford,et al.  Dialysis and skin care. , 2000, Journal of renal nutrition.

[6]  F. Gruijl,et al.  UVB exposure‐induced systemic modulation of Th1‐ and Th2‐mediated immune responses , 1999, Immunology.

[7]  D. Silverberg,et al.  Randomised crossover trial of naltrexone in uraemic pruritus , 1996, The Lancet.

[8]  A. Kuroiwa,et al.  Optimal dialysis improves uremic pruritus. , 1995, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[9]  M. Lóden The increase in skin hydration after application of emollients with different amounts of lipids. , 1992, Acta dermato-venereologica.

[10]  O. Mcbride,et al.  Assignment of the human cyclin D3 gene (CCND3) to chromosome 6p----q13. , 1992, Cytogenetics and cell genetics.

[11]  L. Djukanovic,et al.  Uremic pruritus and skin mast cells. , 1992, Nephron.

[12]  G. Piccoli,et al.  What is the role of sensitization in uremic pruritus? An allergologic study. , 1991, Nephron.

[13]  S. Y. El-Gammal Aromatherapy throughout history. , 1990, Hamdard medicus.

[14]  M. Hilliges,et al.  Intraepidermal neuron-specific enolase (NSE)-immunoreactive nerve fibres: Evidence for sprouting in uremic patients on maintenance hemodialysis , 1989, Neuroscience Letters.

[15]  F. Stockenhuber,et al.  Increased plasma histamine levels in chronic renal failure. , 1987, The New England journal of medicine.

[16]  S. Denman A review of pruritus. , 1986, Journal of the American Academy of Dermatology.

[17]  A. Menter,et al.  Uremic pruritus: skin divalent ion content and response to ultraviolet phototherapy. , 1985, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[18]  M. Hastings,et al.  Neurotoxic lesions of the anterior hypothalamus disrupt the photoperiodic but not the circadian system of the Syrian hamster. , 1985, Neuroendocrinology.

[19]  C. Ponticelli,et al.  Cutaneous abnormalities in uremic patients. , 1985, Nephron.

[20]  C. Berne,et al.  UV treatment of uraemic pruritus reduces the vitamin A content of the skin , 1984, European journal of clinical investigation.

[21]  R. Stern,et al.  Clinical features of pruritus among patients undergoing maintenance hemodialysis. , 1982, Archives of dermatology.

[22]  K. Arndt,et al.  Relief of uremic pruritus with ultraviolet phototherapy. , 1977, The New England journal of medicine.

[23]  M. Reidenberg,et al.  Pruritus in dialysis patients treated with parenteral lidocaine. , 1977, The New England journal of medicine.

[24]  J. Boulton-Jones,et al.  ITCHING IN RENAL FAILURE , 1974 .

[25]  A. Young,et al.  Dermatologic evaluation of pruritus in patients on hemodialysis. , 1973, New York state journal of medicine.

[26]  S. Massry,et al.  Intractable pruritus as a manifestation of secondary hyperparathyroidism in uremia. Disappearance of itching after subtotal parathyroidectomy. , 1968, The New England journal of medicine.

[27]  A. Katz,et al.  Disappearance of "uremic" itching after subtotal parathyroidectomy. , 1968, The New England journal of medicine.