Chronic Kidney Disease-Associated Pruritus

Pruritus is a distressing condition associated with end-stage renal disease (ESRD), advanced chronic kidney disease (CKD), as well as maintenance dialysis and adversely affects the quality of life (QOL) of these patients. It has been reported to range from 20% to as high as 90%. The mechanism of CKD-associated pruritus (CKD-aP) has not been clearly identified, and many theories have been proposed to explain it. Many risk factors have been found to be associated with CKD-aP. The pruritus in CKD presents with diverse clinical features, and there are no set features to diagnose it.The patients with CKD-aP are mainly treated by nephrologists, primary care doctors, and dermatologists. Many treatments have been tried but nothing has been effective. The search of literature included peer-reviewed articles, including clinical trials and scientific reviews. Literature was identified through March 2021, and references of respective articles and only articles published in the English language were included.

[1]  J. Szepietowski,et al.  Clinical Characteristics of Itch in Renal Transplant Recipients , 2021, Frontiers in Medicine.

[2]  M. Obeidat,et al.  Elevated interleukin 31 serum levels in hemodialysis patients are associated with uremic pruritus. , 2020, Cytokine.

[3]  V. Verallo-Rowell,et al.  A randomized controlled study of 6% gabapentin topical formulation for chronic kidney disease‐associated pruritus , 2020, International journal of dermatology.

[4]  J. Szepietowski,et al.  Opioid receptors expression in the skin of haemodialysis patients suffering from uraemic pruritus , 2020, Journal of the European Academy of Dermatology and Venereology : JEADV.

[5]  F. Menzaghi,et al.  Randomized Controlled Trial of Difelikefalin for Chronic Pruritus in Hemodialysis Patients , 2020, Kidney international reports.

[6]  T. Hoshino,et al.  Factors Associated with Uremic Pruritus in Patients Undergoing Peritoneal Dialysis , 2020, International journal of nephrology and renovascular disease.

[7]  H. Mizukami,et al.  Role of Dysregulated Ion Channels in Sensory Neurons in Chronic Kidney Disease-Associated Pruritus , 2019, Medicines.

[8]  G. Piccoli,et al.  Charcoal for the management of pruritus and uremic toxins in patients with chronic kidney disease. , 2019, Current opinion in nephrology and hypertension.

[9]  F. Menzaghi,et al.  A Phase 3 Trial of Difelikefalin in Hemodialysis Patients with Pruritus. , 2019, The New England journal of medicine.

[10]  Tinghai Hu,et al.  Clinical features and risk factors of pruritus in patients with chronic renal failure , 2019, Experimental and therapeutic medicine.

[11]  B. Stengel,et al.  Pruritus and Patient Reported Outcomes in Non-Dialysis CKD. , 2019, Clinical journal of the American Society of Nephrology : CJASN.

[12]  Imatullah Akyar,et al.  Multidimensional pruritus assessment in hemodialysis patients , 2019, BMC Nephrology.

[13]  M. E. Ibrahim,et al.  Evaluation of serum levels of neurotrophin 4 and brain-derived nerve growth factor in uremic pruritus patients , 2019, Clinical, cosmetic and investigational dermatology.

[14]  C. Weng,et al.  Association Between Serum Aluminum Level and Uremic Pruritus in Hemodialysis Patients , 2018, Scientific Reports.

[15]  Jenq-Wen Huang,et al.  Prognostic importance and determinants of uremic pruritus in patients receiving peritoneal dialysis: A prospective cohort study , 2018, PloS one.

[16]  R. Sapam,et al.  Role of narrow band ultra violet radiation as an add-on therapy in peritoneal dialysis patients with refractory uremic pruritus , 2018, World journal of nephrology.

[17]  J. Szepietowski,et al.  End-Stage Renal Disease Chronic Itch and Its Management. , 2018, Dermatologic clinics.

[18]  N. Ozen,et al.  Uremic pruritus and associated factors in hemodialysis patients: A multi-center study , 2018, Kidney research and clinical practice.

[19]  Mei Yang,et al.  Prevalence of chronic kidney disease-associated pruritus among adult dialysis patients , 2018, Medicine.

[20]  Shapour Badiee Aval,et al.  A Systematic Review and Meta-analysis of Using Acupuncture and Acupressure for Uremic Pruritus. , 2018, Iranian journal of kidney diseases.

[21]  Z. Hong,et al.  UPLC-QTOF MS-Based Serum Metabolomic Profiling Analysis Reveals the Molecular Perturbations Underlying Uremic Pruritus , 2018, BioMed research international.

[22]  V. Mathur,et al.  A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial of Nalbuphine ER Tablets for Uremic Pruritus , 2017, American Journal of Nephrology.

[23]  T. Hasegawa,et al.  International Comparisons of Prevalence, Awareness, and Treatment of Pruritus in People on Hemodialysis. , 2017, Clinical journal of the American Society of Nephrology : CJASN.

[24]  N. Tangri,et al.  Treatment of Uremic Pruritus: A Systematic Review. , 2017, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[25]  M. Binitha,et al.  A controlled trial of narrowband ultraviolet B phototherapy for the treatment of uremic pruritus , 2017, Indian journal of dermatology, venereology and leprology.

[26]  F. Tsai,et al.  Transformation of 5-D itch scale and numerical rating scale in chronic hemodialysis patients , 2017, BMC Nephrology.

[27]  S. Shirazian,et al.  Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges , 2017, International journal of nephrology and renovascular disease.

[28]  J. Hayden,et al.  Targeting the Opioid Pathway for Uremic Pruritus , 2016, Canadian journal of kidney health and disease.

[29]  C. Weng,et al.  Environmental NO2 and CO Exposure: Ignored Factors Associated with Uremic Pruritus in Patients Undergoing Hemodialysis , 2016, Scientific Reports.

[30]  J. Szepietowski,et al.  Lipid Content and Barrier Function Analysis in Uraemic Pruritus. , 2016, Acta dermato-venereologica.

[31]  S. Wen,et al.  A Comparison of Uremic Pruritus in Patients Receiving Peritoneal Dialysis and Hemodialysis , 2016, Medicine.

[32]  Chul-woo Yang,et al.  Comparison of uremic pruritus between patients undergoing hemodialysis and peritoneal dialysis , 2016, Kidney research and clinical practice.

[33]  S. Kwatra,et al.  Thalidomide for the treatment of chronic refractory pruritus. , 2016, Journal of the American Academy of Dermatology.

[34]  T. Lau,et al.  Gabapentin for uremic pruritus in hemodialysis patients: a qualitative systematic review , 2016, Canadian journal of kidney health and disease.

[35]  A. Thakur,et al.  Phototherapy as a Treatment for Uremic Pruritus - A Review , 2015 .

[36]  J. P. Teixeira,et al.  Pruritus in Kidney Disease. , 2015, Seminars in nephrology.

[37]  A. Hawi,et al.  Pharmacokinetics of nalbuphine hydrochloride extended release tablets in hemodialysis patients with exploratory effect on pruritus , 2015, BMC Nephrology.

[38]  Sung Bin Cho,et al.  Epidermal Proteinase-Activated Receptor-2 Expression is Increased in End-Stage Renal Disease Patients with Pruritus: A Pilot Study , 2014, Electrolyte & blood pressure : E & BP.

[39]  S. Jee,et al.  Interleukin-31 is associated with uremic pruritus in patients receiving hemodialysis. , 2014, Journal of the American Academy of Dermatology.

[40]  Y. Tomino,et al.  B-type (brain) natriuretic peptide and pruritus in hemodialysis patients , 2014, International journal of nephrology and renovascular disease.

[41]  M. Szczepańska,et al.  Disturbed skin barrier in children with chronic kidney disease , 2014, Pediatric Nephrology.

[42]  S. Fukuhara,et al.  Pruritus in hemodialysis patients: Results from the Japanese Dialysis Outcomes and Practice Patterns Study (JDOPPS) , 2014, Hemodialysis international. International Symposium on Home Hemodialysis.

[43]  A. Claxton,et al.  Clinical characteristics and outcomes of end-stage renal disease patients with self-reported pruritus symptoms , 2013, International journal of nephrology and renovascular disease.

[44]  S. Jee,et al.  Uremic Pruritus, Dialysis Adequacy, and Metabolic Profiles in Hemodialysis Patients: A Prospective 5-Year Cohort Study , 2013, PloS one.

[45]  I. Dasgupta,et al.  Uraemic Pruritus: Relief of Itching by Gabapentin and Pregabalin , 2013, Nephron Clinical Practice.

[46]  D. Santoro,et al.  Pain in end-stage renal disease: a frequent and neglected clinical problem. , 2012, Clinical nephrology.

[47]  E. Ghanei,et al.  Efficacy of omega-3 fatty acids supplementation in treatment of uremic pruritus in hemodialysis patients: a double-blind randomized controlled trial , 2012, Iranian Red Crescent medical journal.

[48]  M. Milani,et al.  Efficacy of topical hydrating and emollient lotion containing 10% urea ISDIN® plus dexpanthenol (Ureadin Rx 10) in the treatment of skin xerosis and pruritus in hemodialyzed patients: an open prospective pilot trial. , 2011, Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia.

[49]  C. Ponticelli,et al.  Randomized, double-blind study with glycerol and paraffin in uremic xerosis. , 2011, Clinical journal of the American Society of Nephrology : CJASN.

[50]  Raymond Miller,et al.  A Comparison of the Pharmacokinetics and Pharmacodynamics of Pregabalin and Gabapentin , 2010, Clinical pharmacokinetics.

[51]  J. Tumlin,et al.  A longitudinal study of uremic pruritus in hemodialysis patients. , 2010, Clinical journal of the American Society of Nephrology : CJASN.

[52]  E. Ernst,et al.  Systematic review of topical capsaicin in the treatment of pruritus , 2010, International journal of dermatology.

[53]  F. Camacho,et al.  A pramoxine-based anti-itch lotion is more effective than a control lotion for the treatment of uremic pruritus in adult hemodialysis patients , 2009, The Journal of dermatological treatment.

[54]  B. Freedman,et al.  An update on pruritus associated with CKD. , 2007, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[55]  F. Port,et al.  Pruritus in haemodialysis patients: International results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). , 2006, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[56]  Mai-Szu Wu,et al.  Therapeutic effect of topical gamma-linolenic acid on refractory uremic pruritus. , 2006, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[57]  M. Rosner Cromolyn sodium: A potential therapy for uremic pruritus? , 2006, Hemodialysis international. International Symposium on Home Hemodialysis.

[58]  M. Kimmel,et al.  The role of micro-inflammation in the pathogenesis of uraemic pruritus in haemodialysis patients. , 2006, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[59]  Y. Ueno,et al.  Kappa-opioid system in uremic pruritus: multicenter, randomized, double-blind, placebo-controlled clinical studies. , 2005, Journal of the American Society of Nephrology : JASN.

[60]  M. Dugas,et al.  Baseline serum levels of mast cell tryptase are raised in hemodialysis patients and associated with severity of pruritus , 2005, Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG.

[61]  Koichi Matsumoto,et al.  Effect of Skin Care With an Emollient Containing a High Water Content on Mild Uremic Pruritus , 2004, Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy.

[62]  D. Horrobin,et al.  Effects of Oral Supplementation with Evening Primrose Oil for Six Weeks on Plasma Essential Fatty Acids and Uremic Skin Symptoms in Hemodialysis Patients , 1999, Nephron.

[63]  D. Tarng,et al.  Uremic pruritus: roles of parathyroid hormone and substance P. , 1997, Journal of the American Academy of Dermatology.

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

[65]  A. Besarab,et al.  Elevated Plasma Histamine in Chronic Uremia Effects of Ketotifen on Pruritus , 1991, International journal of dermatology.

[66]  K. Ichimaru,et al.  Pruritus and mast cell proliferation of the skin in end stage renal failure. , 1985, Clinical nephrology.

[67]  J. Pederson,et al.  Relief of idiopathic generalized pruritus in dialysis patients treated with activated oral charcoal. , 1980, Annals of internal medicine.

[68]  A. Iaina,et al.  Cholestyramine in uraemic pruritus. , 1977, British medical journal.

[69]  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.

[70]  A. Hafezi,et al.  Comparison of Gabapentin and Ketotifen in Treatment of Uremic Pruritus in Hemodialysis Patients , 2016, Pakistan journal of medical sciences.

[71]  G. Trajkovic,et al.  Parametres of clinical and biohumoral status of pruritus in patients on chronic haemodialysis. , 2007, Medicinski pregled.

[72]  G. Yosipovitch,et al.  Nocturnal itch: why do we itch at night? , 2007, Acta dermato-venereologica.

[73]  S. Sheen-Chen,et al.  A study on pruritus after parathyroidectomy for secondary hyperparathyroidism. , 2000, Journal of the American College of Surgeons.

[74]  N. Tamimi,et al.  Role of gamma-linolenic acid in uraemic pruritus. , 1999, Nephron.

[75]  R. Schwartz,et al.  Uremic pruritus , 1998, International journal of dermatology.

[76]  D. Tarng,et al.  Hemodialysis-related pruritus: a double-blind, placebo-controlled, crossover study of capsaicin 0.025% cream. , 1996, Nephron.

[77]  J. Lugon,et al.  Thalidomide for the treatment of uremic pruritus: a crossover randomized double-blind trial. , 1994, Nephron.

[78]  M. Ståhle-Bäckdahl Pruritus in hemodialysis patients. , 1992, Skin pharmacology : the official journal of the Skin Pharmacology Society.