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Uraemic pruritus

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Itch (uraemic pruritus) is a common symptom in people with endstage kidney disease (ESKD)

  • affects 42% to 57% of people on dialysis

Despite its high prevalence, mechanisms driving uraemic itch remain poorly understood

  • two common theories implicate hyperactive and disordered immune or opioid systems
    • roles have also been proposed for hyperparathyroidism, abnormal serum chemistry, mast cell hyperactivity, and dialysis technique

Management (1):

  • evidence that gabapentinoids (gabapentin and pregabalin) show the greatest reduction in itch scores
  • evidence for oral montelukast, turmeric, zinc sulfate, and topical capsaicin also showed an itch score reduction. However, these reductions
    were reported in small studies, and warrant further investigation

Reference

  • Hercz D et al.Interventions for itch in people with advanced chronic kidney disease. Cochrane Database of Systematic Reviews 2020, Issue 12. Art. No.: CD011393. DOI: 10.1002/14651858.CD011393.pub2.

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