Effects of Fumaria parviflora L on Uremic Pruritus in Hemodialysis Patients: A Randomized, Double-Blind, Placebo-Controlled Trial

Abstract

Background: Uremic pruritus (UP) is a common, bothersome symptom in hemodialysis (HD) patients with end-stage renal disease. Immunohypothesis is currently favored as an explanation of the cause of UP. Fumaria parviflora L (FP) is a medicinal herb with several pharmacological properties, including prominent anti-inflammatory activity. Objectives: This study aimed to assess the efficacy of FP for reducing UP severity among HD patients. Methods: A total of 79 HD patients with pruritus were randomly assigned to receive either FP or a placebo for eight weeks. The visual analogue scale (VAS), the Duo score for calculating pruritus score, serum interferon-γ (IFN-γ) level, interleukin-4 (IL-4), and high-sensitivity C-reactive protein were measured in the patients before and after treatment. Results: At the end of the treatment phase, the pruritus score decreased in both groups (P < 0.001); however, the mean reduction in pruritus scores was significantly higher in the FP group than the placebo group according to VAS (-6.15 ± 2.12 vs. -2.25 ± 2.46, P < 0.001) and Duo scores (-22.03 ± 9.64 vs. -8.38 ± 6.28, P < 0.001). IFN-γ mean serum levels in the FP group significantly decreased (P < 0.001), but there was no significant change in these levels in the placebo group (P = 0.604). The elevation of the mean serum IL-4 level was significant in the FP group (P = 0.028) but not in the placebo group (p = 0.100). Conclusions: FP can significantly decrease the severity of UP in HD patients.