Abstract
Several blood parameters and serum biochemical values have been associated with pruritus in hemodialysis (HD) patients. However, the pathogenesis of uremic pruritus (UP) is still obscure. It is of interest to find some blood values that can predict the progression of pruritus from mild to severe in HD patients. The occurrence of pruritus, its duration, severity and correlation with patient’s laboratory data was evaluated. Blood samples from hemodialysis patients and hemodialysis patients with mild, moderate, and severe pruritus were taken during the dialysis. In addition, blood samples from non-renal failure normal control. The association between severity of pruritus and blood and serum laboratory parameter including, RBCs, HCT%, Hb, total and differentiation WBC counts were evaluated. In addition, the relationships of total protein, albumin, globulin, IgA. IgM, IgG, and IgE with severity of pruritus were examined. In general CBC values slightly decreased in the pruritus patients when compared with control group, however, the differences were not statistically significant (P > 0.05). The Hb and HCT% were not different. However, there was a neutropenia observed in patients with pruritus as compared to the control. Similarly, compared to the HD control, lymphocytes and monocytes slightly decreased in pruritius patients, while basophils slightly increased. However, these differences were not statistically significant. There was a significant increase in eosinophils absolute numbers in the pruritus groups when compared with that of the HD control group. On the other hand, serum total protein, albumin and globulin concentration in normal control and hemodialysis patients with and without pruritus were not statistically different. Our study demonstrated that there was a highly significant decrease in serum level of IgA, IgG, and IgM levels in pruritus patients compared to that of the control groups. IgA level decreased in pruiritus patients compared to the HD control. Except for mild pruritus patients, IgM and IgG increased in pruritus patients compared to the HD control with no pruritus. On the other hand, IgE showed significant increase as the pruritus becomes severer. The highest IgE value was observed in the severe pruritus compared with the non-pruritus control and the mild and moderate pruritus groups. Increased IgE may have led to eosinophilia in hemodialysis patients with pruritus. It seems that there is possible link between the dialyzing membrane, pruritus, eosinophilia, and IgE, and this link necessitates future studies.
Highlights
Uremic pruritus (UP) is still one of the annoying symptoms for patients with chronic renal failure undergoing hemodialysis
Total white blood cell counts and the number of granulocytes and monocytes were significantly higher in the end stage renal disease (ESRD) patients as compared to the corresponding values found in the control group
Our results showed that the pruritus patients are anemic, they are not different from their HD control
Summary
Uremic pruritus (UP) is still one of the annoying symptoms for patients with chronic renal failure undergoing hemodialysis. Compounds that tend to increase in levels in the blood and tissues during the development of end stage renal disease (ESRD) are defined as uremic retention solutes [2]. Total white blood cell counts and the number of granulocytes and monocytes were significantly higher in the ESRD patients as compared to the corresponding values found in the control group. Doi:10.4172/2161-1009.1000246 biochemical values (cortisol, histamine, IL-2 and IL-6) had increased significantly in uremic patients compared to hemodialysis patients control, and healthy patients Their results suggest that many factors may have important role in pathogenesis and progression of uremic pruritus from mild to severe. This study was designed to investigate the association between the severity of pruritus and complete blood count (CBC), and serum biochemical parameters, including levels of total proteins, albumin, globulins, and immunoglobulins (IgA, IgM, IgG, and IgE)
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