Frequency and possible pathogenesis of chronic renal failure-associated pruritus in dialyzed patients

Abstract

Background Uremic pruritus is a common dermatological problem in patients on hemodialysis. The pathogenesis is not fully understood; it is a multifactorial infection. The aim of this study was to identify the frequency of pruritus in patients with chronic renal failure on hemodialysis and its association with serum electrolytes (Ca and P), level of parathyroid hormones (PTH), and dialysis adequacy. Patients and methods A total of 60 patients with chronic renal failure on hemodialysis were included in the present study from dialysis unit in the Faculty of Medicine, Assuit University Hospital. Data were collected according to a structural questionnaire, including age, sex, and duration of dialysis. The authors investigated sociodemographic data, and several biochemical tests, such as calcium, phosphorus, kidney functions, and PTH, were performed to know their association with uremic pruritus. All patients,from them is corrected and deleted it so the sentence become as follow: A detailed description of the study and written informed consent was obtained. The study was registered with IRB no.17101062. Results This study revealed that the prevalence of pruritus was higher in males than females, and also, there was no association with age. Of all biochemical tests, phosphorus, PTH, and duration of dialysis showed significant association with pruritus (P=0.043, 0.000, and 0.030, respectively). The association between PTH and the other study variables showed that significant association with calcium (P=0.012). The dialysis adequacy showed no significant association with other variables. Conclusion Uremic pruritus is a common problem, occurring in ~64.9% in patients with chronic kidney disease on hemodialysis. In this study, the authors found that increase in PTH level, increase in serum phosphorus, dialysis adequacy, and xerosis play a major role in pathogenesis of renal pruritus. The authors recommend from this study regular follow-up of patients treated for more than 6 months with hemodialysis, with regular measurement of PTH level and serum phosphorus and their proper management to prevent appearance of renal pruritus and use of novel approaches such as tacrolimus ointment, oral activated charcoal, phototherapy, acupuncture, and kidney transplantation.