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Renal Pruritus

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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Jia-Wen Lai, Hung-Chih Chen, Che-Yi Chou, Hung-Rong Yen, Tsai-Chung Li, Mao-Feng Sun, Hen-Hong Chang, Chiu-Ching Huang, Fuu-Jen Tsai, Johannes Tschen, Chiz-Tzung Chang
BACKGROUND: Pruritus is a common and frustrating symptom in hemodialysis (HD) patients and 5-D itch scale is proposed as a reliable measurement of pruritus. However, information regarding 5-D itch scale categories is currently unavailable. We explored optimal cut-offs 5-D itching scale based on numerical rating scale (NRS) categories in HD patients. METHODS: Four hundred and nine HD patients in China Medical University Hospital in December 2014 were included and severity of pruritus was estimated using NRS and 5-D itch scale...
February 8, 2017: BMC Nephrology
Shayan Shirazian, Olufemi Aina, Youngjun Park, Nawsheen Chowdhury, Kathleen Leger, Linle Hou, Nobuyuki Miyawaki, Vandana S Mathur
Chronic kidney disease-associated pruritus (CKD-aP) is a distressing, often overlooked condition in patients with CKD and end-stage renal disease. It affects ~40% of patients with end-stage renal disease and has been associated with poor quality of life, poor sleep, depression, and mortality. Prevalence estimates vary based on the instruments used to diagnose CKD-aP, and standardized diagnostic instruments are sorely needed. Treatment studies have often yielded conflicting results. This is likely related to studies that are limited by small sample size, flawed designs, and nonstandardized diagnostic instruments...
2017: International Journal of Nephrology and Renovascular Disease
Akishi Momose, Yasuo Shiraiwa, Satoshi Narita, Tomomi Kusumi, Shoko Goto, Koichiro Sera
BACKGROUND/AIMS: In our earlier studies, we reported high concentrations of intra- and extracellular calcium ions (Ca2+) in the deeper epidermis of patients with chronic kidney disease (CKD) and associated pruritus. To determine the cause of this phenomenon, we measured total calcium (TCa) concentrations in the deeper epidermis and performed immunostaining of epidermal albumin, which binds to Ca2+. METHODS: This study included 45 patients with CKD-stage 5, which was defined as severely reduced kidney function (i...
February 10, 2017: Nephron
Lízie Emanuelle Eulalio Brasileiro, Dayanna Patrícia de Carvalho Barreto, Emerson Arcoverde Nunes
Among the wide range of symptoms neglected or resistant to conventional treatments in clinical practice, itch is emerging gradually as a theme to be studied. Itch complaints and the negative effects in the quality of life are observed in several medical fields. Although the partially obscure pathophysiology, some researchers decided to check and test the use of psychotropic drugs in resistant itch to conventional topical treatments and antihistamines. The objective of this study was to evaluate scientific evidence in psychotropic use in the treatment of itch of various causes...
November 2016: Anais Brasileiros de Dermatologia
Yunes Panahi, Simin Dashti-Khavidaki, Farahnoosh Farnood, Hamid Noshad, Mahsa Lotfi, Afshin Gharekhani
Uremic pruritus remains one of the most tormenting, frequent and potentially disabling problem in chronic kidney disease (CKD) patients. However, an area of substantial etiological interest with relation to uremic pruritus is the essential fatty acids deficiency. So we performed a literature review to elucidate the efficacy of omega-3 fatty acids on uremic pruritus. This review evaluated all of the studies published in English language, focusing on the clinical effects of omega-3 fatty acids on uremic pruritus...
December 2016: Advanced Pharmaceutical Bulletin
Helene Tarp, Malene Bonde-Petersen, Jeanette Finderup
BACKGROUND: Uraemic pruritus (UP) is one of the most frequent symptoms for patients in haemodialysis. Studies show that UP decreases quality of life including sleep. Patients find it difficult to describe the symptoms of UP to healthcare professionals. OBJECTIVES: To explore how patients in haemodialysis experience the phenomenon of UP. METHODS: A qualitative phenomenological-hermeneutic framework was used. Fifteen semi-structured interviews were undertaken at a Danish university hospital in November 2015...
March 2017: Journal of Renal Care
Vincenzo Panuccio, Rocco Tripepi, Marianna Bellantoni, Licia Saporito, Serena Quattrone, Viviana Lacava, Giovanna Parlongo, Giovanni Tripepi, Francesca Mallamaci, Carmine Zoccali
BACKGROUND: Pruritus has a negative impact on quality of life (QoL) in dialysis patients. The reversibility of this symptom after renal transplantation and its impact upon QoL has scarcely been studied in these patients. METHODS: Pruritus was evaluated by the Visual Analogue Scale (VAS), the Visual Rating Scale (VRS), and the Numerical Rating Scale (NRS) in 133 unselected renal transplant patients, 62 healthy subjects, and 29 hemodialysis patients. QoL was assessed by KDQOL-SF(™) 1...
December 17, 2016: Clinical Transplantation
Ji-Won Min, Su-Hyun Kim, Young Ok Kim, Dong Chan Jin, Ho Chul Song, Euy Jin Choi, Yong-Lim Kim, Yon-Su Kim, Shin-Wook Kang, Nam-Ho Kim, Chul Woo Yang, Yong Kyun Kim
BACKGROUND: Uremic pruritus is a common, but unpleasant, complication of end-stage renal disease. The uremic burden may differ between hemodialysis (HD) and peritoneal dialysis (PD) patients. This difference may also change the clinical characteristics of uremic pruritus between the 2 modalities. In this study, we investigated the uremic pruritus between patients on HD and PD. METHODS: A total of 425 HD and 223 PD patients from the Clinical Research Center registry in Korea were included...
June 2016: Kidney Research and Clinical Practice
Michael Joseph Lavery, Carolyn Stull, Michael Owen Kinney, Gil Yosipovitch
Chronic pruritus is a debilitating condition with numerous etiologies. Many patients suffer from nocturnal pruritus, which can decrease quality of life and affect mortality in hemodialysis patients. Nocturnal pruritus may occur in all sleep stages but is most prevalent in stages N1 and N2. Further research is needed to elucidate the pathophysiology of nocturnal itch, which will aid in the development of tailored management strategies.
March 22, 2016: International Journal of Molecular Sciences
Saeid Amirkhanlou, Anna Rashedi, Jalal Taherian, Ali Akbar Hafezi, Sahar Parsaei
OBJECTIVES: Uremic pruritus is a common problem in hemodialysis patients. Several treatments have been used for decreasing itching in these patients. Gabapentin and ketotifen are two drugs used for treating uremic patients. The aim of this study was to compare gabapentin and ketotifen in treatment of uremic pruritus in hemodialysis patients. METHODS: In this double-blind randomized clinical trial, 52 hemodialysis patients with uremic pruritus referred to 5azarTeaching Hospital in Gorgan in 2013 were studied...
January 2016: Pakistan Journal of Medical Sciences Quarterly
Torey Lau, Sharon Leung, Wynnie Lau
PURPOSE OF THE REVIEW: Uremic pruritus (UP) is a common discomfort of dialysis-dependent end-stage renal disease. Some studies suggest a neuropathic cause of UP. Gabapentin, an anticonvulsant, has shown promising results as an emerging drug to treat this condition. OBJECTIVE: An updated qualitative systematic review was conducted to evaluate its efficacy and safety in hemodialysis patients. SOURCE OF INFORMATION: Ovid MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Clinicaltrials...
2016: Canadian Journal of Kidney Health and Disease
Eman Nofal, Fawzia Farag, Ahmad Nofal, Fatma Eldesouky, Reham Alkot, Zeinab Abdelkhalik
BACKGROUND: Treatment of uremic pruritus (UP) is a big challenge. OBJECTIVES: To evaluate efficacy, appropriate dosing regimen and safety of gabapentin on UP in hemodialysis (HD) patients. PATIENTS AND METHODS: Fifty-four uremic patients undergoing HD and complaining of UP were randomly classified into two equal groups. Gabapentin group: 27 patients received gabapentin capsules starting with 100 mg and gradually titrated up to a maximum of 300 mg after each HD session for one month...
November 2016: Journal of Dermatological Treatment
Tahir Mehmood Khan, Abdul Aziz, Amal K Suleiman
Uremic pruritus (UP) is one of the complications faced by majority of the patients with end stage renal disease (ESRD). Due to complex pathophysiology of UP, most of the anti-inflammatory and tropical lubricants often not provide a long lasting control over pruritus. Recently the uses of certain anti-epileptics are found to demonstrate promising relief to UP. To test the effect of 75 mg pregabalin in patients with treatment resistance pruritus. Data was prospectively collected from a patient with ESRD and suffering from treatment resistance pruritus...
January 2016: Journal of Pharmacy & Bioallied Sciences
Berna Solak, Seyyid Bilal Acikgoz, Savas Sipahi, Teoman Erdem
PURPOSE: There are only a few small studies investigating chronic kidney disease-associated pruritus (CKD-P) in pre-dialysis chronic kidney disease (CKD). None of these has taken into account the associations of CKD-P with clinical features and laboratory data. We aimed to study prevalence of and clinical and laboratory associates of CKD-P in pre-dialysis CKD patients. METHODS: A total of 402 consecutive stage 2-5 pre-dialysis CKD patients were included in this cross-sectional study...
April 2016: International Urology and Nephrology
Carolyn Stull, Michael J Lavery, Gil Yosipovitch
INTRODUCTION: Chronic pruritus is a common symptom that arises from both dermatologic and non-dermatologic conditions including chronic kidney disease, cholestasis, lymphoma and neuropathy. Over the past decade, research has elucidated many of the receptors, neuropeptides and cytokines involved in itch sensation and transmission. In addition, the first biomarker for cholestatic itch has been discovered. These findings have led to the development of a host of novel antipruritic medications, both on the market and in the pipeline...
2016: Expert Opinion on Pharmacotherapy
E Weisshaar
Chronic itch (CI) is a frequent and impairing symptom in haemodialysis (HD) patients. Within the last decades, worldwide variations were reported in the prevalence of itch in HD patients, ranging from 10 to 77%. Regional differences and especially the irregular pattern of itch in HD may explain why CI is still not well perceived and underestimated in HD patients. The pathogenesis is still unclear and therapy is ineffective in the majority of cases. There is a great diversity of prevalence estimates of itch used in different studies as well, as the study population greatly differs, especially when investigating CI in HD...
January 2016: European Journal of Pain: EJP
Sara A Combs, J Pedro Teixeira, Michael J Germain
Pruritus is a common and distressing symptom in patients with chronic kidney disease. The most recent epidemiologic data have suggested that approximately 40% of patients with end-stage renal disease experience moderate to severe pruritus and that uremic pruritus (UP) has a major clinical impact, being associated strongly with poor quality of life, impaired sleep, depression, and increased mortality. The pathogenesis of UP remains largely unclear, although several theories on etiologic or contributing factors have been proposed including increased systemic inflammation; abnormal serum parathyroid hormone, calcium, and phosphorus levels; an imbalance in opiate receptors; and a neuropathic process...
July 2015: Seminars in Nephrology
Samaneh Nakhaee, Ahmad Nasiri, Yadollah Waghei, Jamileh Morshedi
INTRODUCTION: Uremic pruritus is a common complication in patients with chronic kidney disease. While its cause is not known for certain, different treatments are currently applied. This study aimed to compare the effects of Avena sativa, diluted vinegar, and hydroxyzine on the reduction of uremic pruritus. MATERIALS AND METHODS: In this crossover randomized clinical trial, 23 hemodialysis patients with uremic pruritus were randomly divided into 3 groups. The first group was treated with Avena sativa lotion, twice a day, for as long as 2 weeks; the second group received diluted vinegar; and the third group took hydroxyzine tablets for the same time span...
July 2015: Iranian Journal of Kidney Diseases
J C Robles-Mendez, O Vazquez-Martinez, J Ocampo-Candiani
Skin manifestations associated with chronic kidney disease are very common. Most of these conditions present in the end stages and may affect the patient's quality of life. Knowledge of these entities can contribute to establishing an accurate diagnosis and prognosis. Severe renal pruritus is associated with increased mortality and a poor prognosis. Nail exploration can provide clues about albumin and urea levels. Nephrogenic systemic fibrosis is a preventable disease associated with gadolinium contrast. Comorbidities, such as diabetes mellitus and secondary hyperparathyroidism, can lead to acquired perforating dermatosis and calciphylaxis, respectively...
October 2015: Actas Dermo-sifiliográficas
Shigeki Inui
Uremic pruritus has a great negative influence on quality of life in hemodialysis (HD) patients and, importantly, negatively affects mortality risk. Recently, nalfurafine hydrochloride, an opioid κ-selective agonist, has been officially approved for resistant pruritus in HD patients on the basis of a well-evidenced clinical trial in Japan. From clinical observation, it has been suggested that the upper neuron system plays a role in its pathogenesis. According to previous experimental results, using mice injected with opioids, dynorphin suppresses itch through binding κ-opioid receptors, suggesting that κ-opioid opioid receptor agonists act as potential therapeutic reagents for pruritus in HD patients...
2015: Clinical, Cosmetic and Investigational Dermatology
2015-05-28 18:17:20
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