Abstract
Chronic kidney disease-associated pruritus (CKD-aP), also known as uremic pruritus, has been associated with increased mortality and lower quality of life among patients with chronic kidney disease (CKD). The relentless nature of the condition is mainly due to its diverse and complex etiologies, which are still being studied. Despite the introduction of many agents to treat it, the resolution rates of CKD-aP still remain unsatisfactory. This study sought to review the lesser-known/novel treatments and establish a relationship between their mechanism of action and the proposed etiologies implicated in CKD-aP. We also discuss the role of dialysis modification in managing CKD-aP.A decent proportion of the reviewed studies have proposed that the agents analyzed in them act through hampering inflammation. Interestingly, the results of two agents alluded to the role of dysbiosis in CKD-aP. The addition of hemoperfusion to the dialysis regimen of patients with CKD-aP improved the severity of their symptoms.The featured treatments could be tried in patients with intractable symptoms. However, additional research is needed to confirm the findings reported in these studies. A better understanding of the pathologic mechanisms is required to help guide the development of agents that can better treat CKD-aP.
Highlights
BackgroundChronic kidney disease-associated pruritus (CKD-aP), sometimes called uremic pruritus, is a common condition affecting patients with chronic kidney disease (CKD)
CKD-aP affects patients on hemodialysis and peritoneal dialysis to a similar degree; a study on the topic has found that it affected patients on hemodialysis to a lesser extent [1,5]
It has been observed that CKD-aP may persist even after renal transplantation; a study performed in 2020 to determine the prevalence of chronic pruritus among post-renal transplantees revealed a prevalence of 12% [6]
Summary
Chronic kidney disease-associated pruritus (CKD-aP), sometimes called uremic pruritus, is a common condition affecting patients with CKD. A meta-analysis of several observational studies has reported a prevalence of at least 50% in patients on dialysis [1]. CKD-aP is more than just an irritating itch; it has far-reaching effects and has been associated with increased morbidity and mortality and decreased quality of life [2,3,4]. CKD-aP affects patients on hemodialysis and peritoneal dialysis to a similar degree; a study on the topic has found that it affected patients on hemodialysis to a lesser extent [1,5]. It has been observed that CKD-aP may persist even after renal transplantation; a study performed in 2020 to determine the prevalence of chronic pruritus among post-renal transplantees revealed a prevalence of 12% [6]. The patients usually do not exhibit skin lesions [7]
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