Association Between Serum Aluminum Level and Uremic Pruritus in Hemodialysis Patients

Ching-Wei Hsu,Wen-Hung Huang,Ming-Jen Chan,Dan-Tzu Lin-Tan,Tzung-Hai Yen,Cheng-Hao Weng

doi:10.1038/s41598-018-35217-6

Ching-Wei Hsu, Wen-Hung Huang + Show 4 more

Open Access

https://doi.org/10.1038/s41598-018-35217-6

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Abstract

Uremic pruritus (UP) is a common symptom in patients undergoing hemodialysis (HD). The pathogenesis of UP is complex. Aluminum (Al) is a common metal and is toxic to patients undergoing HD. Al is also a known human allergen which can induce immune reactions. However, the correlation between Al and UP remains unclear in dialysis patients. A total of 866 patients on maintenance HD were enrolled for analysis. The HD patients with higher serum Al levels had higher a prevalence of UP than those with lower serum Al levels. After adjusting for confounding variables, the serum Al level was significantly associated with UP. Overall, each 10-fold increase in serum Al level was associated with a 5.64-fold increase in the risk of developing UP in these subjects. The results of this cross-sectional study suggest that serum Al level may be associated with the development of UP in patients on maintenance HD.

Highlights

Aluminum (Al) is a toxic metal in humans, and its cumulative effects have been shown to be detrimental to the health of ESRD patients[5]
The analytical results of this study demonstrated that the maintenance HD patients with a higher serum Al level had a higher prevalence of Uremic pruritus (UP) than those with a lower serum Al level
Following adjustments for confounding variables, the serum Al level was significantly associated with UP in our study patients with ESRD

Summary

Introduction

Aluminum (Al) is a toxic metal in humans, and its cumulative effects have been shown to be detrimental to the health of ESRD patients[5]. An increased serum Al level has been associated with increased risks of dialysis dementia, renal osteodystrophy, anemia and mortality in patients undergoing maintenance HD5,6. The major sources of Al in maintenance HD patients are the water used for dialysate solution and Al-containing phosphate binders[5]. The National Kidney Foundation–Kidney Disease Outcomes Quality Initiative suggests measuring the serum Al levels in maintenance HD patients at least once a year[8]. In 1997, Friga et al demonstrated a positive correlation between serum Al levels and UP in 94 long-term HD patients[9]. The association between serum Al level and UP is uncertain in maintenance HD patients. We conducted this study to investigate the relationship between serum Al level and UP in this population

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