Uraemic pruritus: Clinical characteristics, pathophysiology and treatment

Drugs

Volumn 69, Issue 3, 2009, Pages 251-263

  Manenti, Lucio ^a,c   Tansinda, Pius ^a   Vaglio, Augusto ^b  

^a Division of Nephrology   (Italy)

^b UNIVERSITY OF PARMA   (Italy)

^c Nefrologia e Dialisi   (Italy)

Author keywords

[No Author keywords available]

Indexed keywords

ACTIVATED CARBON; CAPSAICIN; CETIRIZINE; EMOLLIENT AGENT; ERYTHROPOIETIN; GABAPENTIN; GAMMA LINOLENIC ACID; GRANISETRON; LIDOCAINE; NALFURAFINE; NALTREXONE; NICERGOLINE; ONDANSETRON; PENTOXIFYLLINE; POLY(METHYL METHACRYLATE); TACROLIMUS; TERFENADINE; THALIDOMIDE; TROPISETRON;

ACUPUNCTURE; CLINICAL TRIAL; DISEASE ASSOCIATION; HUMAN; KIDNEY FAILURE; PATHOPHYSIOLOGY; PHOTOTHERAPY; PHYSIOTHERAPY; PRURITUS; REVIEW; TREATMENT OUTCOME; TREATMENT RESPONSE; ULTRAVIOLET RADIATION; UREMIA; UREMIC PRURITUS;

ANALGESICS, OPIOID; ANTIPRURITICS; HISTAMINE ANTAGONISTS; HUMANS; KIDNEY FAILURE, CHRONIC; PRURITUS; RENAL DIALYSIS; ULTRAVIOLET THERAPY; UREMIA;

EID: 62149115189     PISSN: 00126667     EISSN: 00126667     Source Type: Journal    
DOI: 10.2165/00003495-200969030-00002     Document Type: Review

References (77)

1. Masi CM, Cohen EP. Dialysis efficacy and itching in renal failure. Nephron 1992; 62: 257-61
2. Pisoni RL, Wikstrom B, Elder SJ, et al. Pruritus in haemodialysis patients: international results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant 2006; 21: 3495-505
3. Mistik S, Utas S, Ferahbas A, et al. An epidemiology study of patients with uremic pruritus. J Eur Acad Dermatol Venereol 2006; 20: 672-8
4. Murphy M, Carmichael AJ. Renal itch. Clin Exp Dermatol 2000; 25: 103-6
5. Zucker I, Yosipovitch G, David M, et al. Prevalence and characterization of uremic pruritus in patients undergoing hemodialysis: uremic pruritus is still a major problem for patients with end-stage renal disease. J Am Acad Dermatol 2003; 49: 842-6
6. Twycross R, Greaves MW, Handwerker H, et al. Itch: scratching more than the surface. QJ Med 2003; 96: 7-26
7. Zakrzewska-Pniewska B, Jedras M. Is pruritus in chronic uremic patients related to peripheral somatic and autonomic neuropathy? Neurophysiol Clin 2001; 31: 181-93
8. Stahle-Backdal M. Pruritus in haemodialysis patients. Skin Pharmacol 1992; 5: 14-20
9. Stockenhuber F, Kurz RW, Setl K, et al. Increased plasma histamine in uremic pruritus. Clin Sci 1990; 79: 477-82
10. Mettang T, Fritz P, Weber J, et al. Uremic pruritus in patients on hemodialysis or continuous ambulatory peritoneal dialysis (CAPD): the role of plasma histamine and skin mast cells. Clin Nephrol 1990; 34: 136-41
11. Hiroshige K, Kabashima N, Takasugi M, et al. Optimal dialysis improves uremic pruritus. Am J Kidney Dis 1995; 25: 413-9
12. Dimkovic N, Djukanovic L, Radmilovic A, et al. Uremic pruritus and skin mast cells. Nephron 1992; 61: 5-9
13. Shim WS, Oh U. Histamine-induced itch and its relationship with pain. Mol Pain 2008 Jul 31; 4: 29
14. Massry SG, Popovtzer MM, Coburn JW, et al. Intractable pruritus as a manifestation of secondary hyperparathiroidism in uremia: disappearance of itching after subtotal parathyroidectomy. N Engl J Med 1968; 279: 697-700
15. Keithy-Reddy SR, Patel TV, Armstrong AW, et al. Uremic pruritus. Kidney Int 2007; 72: 373-7
16. Momose A, Kudo S, Sato M, et al. Calcium ions are abnormally distributed in the skin of haemodialysis patients with uremic pruritus. Nephrol Dial Transplant 2004; 19: 2061-6
17. Akhyani M, Ganmji MR, Samadi N, et al. Pruritus in haemodialysis patients. BMC Dermatol 2005; 5: 7
18. Subach RA, Marx MA. Evaluation of uremic pruritus at an outpatient hemodialysis unit. Ren Fail 2002; 24: 609-14
19. Cho YL, Liu HN, Huang TP, et al. Uremic pruritus: roles of parathiroid hormone and substance P. J Am Acad Dermatol 1998; 38: 503-4
20. t/V: an analysis of error. J Am Soc Nephrol 1993; 4: 1205-13
21. Narita I, Alchi B, Omori K, et al. Etiology and prognostic significance of severe uremic pruritus in chronic hemodialysis patients. Kidney Int 2006; 69: 1626-32
22. Duque MI, Thevarajah S, Chan YH, et al. Uremic pruritus is associated with higher kt/V and serum calcium concentration. Clin Nephrol 2006; 66: 184-91
23. Kimmel M, Alscher DM, Dunst R, et al. The role of microinflammation in the pathogenesis of uraemic pruritus in haemodialysis patients. Nephrol Dial Transplant 2006; 21: 749-55
24. Pauli-Magnus C, Mikus G, Alscher DM, et al. Naltrexone does not relieve uremic pruritus: results of a randomized, placebo-controlled crossover-study. J Am Soc Nephrol 2000; 11: 514-9
25. Bosch-Krakenhaus R. Uremic pruritus is not related to β-endorphin serum levels in haemodialysis patients. Nephrol Dial Transplant 1998; 13: 231-2
26. Wikstrom B, Gellert R, Ladefoged SD, et al. κ-Opioid system in uremic pruritus:multicenter, randomized, double-blind, placebo-controlled clinical studies. J Am Soc Nephrol 2005; 16: 3742-7
27. Weisshaar E, Dunker N, Rohl FW, et al. Antipruritc effects of two different 5-HT3 receptor antagonists and an antihistamine in haemodialysis patients. Exp Dermatol 2004; 13: 298-304
28. Tremont-Lukats IW, Megeff C, Backonja MM. Anticonvulsants for neuropathic pain syndromes. Drugs 2000; 60 (S): 1029-52
29. Schmelz M. Itch and pain. Dermatol Ther 2005; 18: 304-7
30. Kidd BL, Urban LA. Mechanism of inflammatory pain. Br J Anaesth 2001; 87: 3-11
31. Yosipovitch G, Zucker I, Boner G, et al. A questionnaire for the assessment of pruritus: validation in urenic patients. Acta Dermatol Venereol 2001; 81: 108-11
32. Carruthers SG, Larochelle P, Haynes RB, et al. Report of the Canadian Hypertension Society Consensus Conference. I. Introduction. CMAJ 1993; 149: 289-93
33. Kato A, Takita T, Furuhashi M, et al. Polymethylmethacrylate efficacy in reduction of renal itching in hemodialysis patients: crossover study and role of tumor necrosis factor-alpha. Artif Organs 2001; 25: 441-7
34. Lin HH, Liu YL, Liu JH, et al. Uremic pruritus, cytokines and polymethylmethacrilate artificial kidney. Artif Organs 2008; 32: 468-72
35. Aoike I. Clinical significance of protein adsorbable membranes: long-term clinical effects and analysis using a proteomic technique. Nephrol Dial Transplant 2007; 22 Suppl. 5: 13-9
36. Morton CA, Lafferty M, Hau C, et al. Pruritus and skin hydration during dialysis. Nephrol Dial Transplant 1996; 11: 2031-6
37. Okada K, Matsumoto K. Effect of skin care with an emollient containing a high water content on mild uremic pruritus. Ther Apher Dial 2004; 8: 419-22
38. Szepietowski JC, Reich A, Szepietowski T. Emollients with endocannabinoids in the treatment of uremic pruritus: discussion of the therapeutic options. Ther Apher Dial 2005; 9: 277-9
39. Chen YC, Chiu WT, Wu MS. Therapeutic effect of topical gamma-linolenic acid on refractory uremic pruritus. Am J Kidney Dis 2006; 48: 69-76
40. Breneman DL, Cardone S, Blumsack RF, et al. Topical capsaicin for treatment of hemodialysis-related pruritus. J Am Acad Dermatol 1992; 26: 91-4
41. Tarng DC, Cho YL, Liu HN, et al. Hemodialysis-related pruritus: a double-blind. Placebo-controlled, crossover study of capsaicin 0.025%cream. Nephron 1996; 72: 617-22
42. Weisshaar E, Dunker N, Gollnick H. Topical capsaicin therapy in humans with hemodialysis-related pruritus. Neurosci Lett 2003; 345: 192-4
43. Kuypers DR, Claes K, Evenepoel P, et al. A prospective proof of concept study of the efficacy of tacrolimus ointment on uremic pruritus (UP) in patients on chronic dialysis therapy. Nephrol Dial Transplant 2004; 19: 1895-901
44. Duque MI, Yosipovitch G, Fleischer AB, et al. Lack of efficacy of tacrolimus ointment 0,1% for treatment of hemodialysis-related pruritus: a randomized, double blind, vehicle-controlled study. J Am Acad Dermatol 2005; 52: 519-21
45. Gilchrest BA, Rowe JW, Brown RS, et al. Relief of uremic pruritus with ultraviolet phototherapy. N Engl J Med 1977; 297: 136-8
46. Schultz BC, Roenigk HH. Uremic pruritus treated with ultraviolet light. JAMA 1980; 243: 1836-7
47. Seckin D, Demircay Z, Akin O. Generalized pruritus treated with narrowband UVB. Int J Dermatol 2007; 46: 367-70
48. Gao H, Zhang W, Wang Y. Acupuncture treatment for 34 cases of uremic cutaneous pruritus. J Tradit Chin Med 2002; 22: 29-30
49. Che-yi C, Wen CY, Min-Tsung K, et al. Acupuncture in haemodialysis patients at the Quchi (LI11) acupoint for refractory uraemic pruritus. Nephrol Dial Transplant 2005; 20: 1912-5
50. Russo GE, Spaziani M, Guidotti C, et al. Pruritus in chronic uremic patients in periodic hemodialysis: treatment with terfenadine (an antagonist of histamine H1 receptors) [in Italian]. Minerva Urol Nephrol 1986; 38: 443-7
51. Balaskas EV, Bamihas GI, Karamouzis M, et al. Histamine and serotonine in uremic pruritus: effect of ondasetron in CAPD-pruritc patients. Nephron 1998; 78: 395-402
52. Ashmore SD, Jones CH, Newstead CG, et al. Ondasetron therapy for uremic pruritus in hemodialysis patients. Am J Kidney Dis 2000; 35: 827-31
53. Murphy M, Realch D, Pai P, et al. A randomized, placebo-controlled, double blind trial of ondasetron in renal itch. Br J Dermatol 2003; 148: 314-7
54. Layegh P, Mojahedi MJ, Malekshah PET, et al. Effect of oral granisetron in uremic pruritus. Indian J Dermatol Venereol Leprol 2007; 73: 231-4
55. Peer G, Kivity S, Agami O. Randomized crossover trial of naltrexone in uremic pruritus. Lancet 1996; 348: 1552-4
56. Legroux-Crespel E, Cledes J, Misery L. A comparative study on the effects of naltrexone and loratadine on uremic pruritus. Dermatology 2004; 208: 326-30
57. Manenti L, Vaglio A, Costantino E, et al. Gabapentin in the treatment of uremic itch: an index case and a pilot evaluation. J Nephrol 2005; 18: 86-91
58. Gunal AI, Ozalp G, Yoldas TK, et al. Gabapentin therapy for pruritus in haemodialysis patients: a randomized, placebo-controlled, double-blind trial. Nephrol Dial Transplant 2004; 19: 3137-9
59. Naini AE, Harandi AA, Khanbabapour S, et al. Gabapentin: a promising drug for the treatment of uremic pruritus. Saudi J Kidney Dis Transpl 2007; 18: 378-81
60. Silva SR, Viana PC, Lugon NV, et al. Thalidomide for the treatment of uremic pruritus: a crossover randomized double-blind trial. Nephron 1994; 67: 2011-2
61. De Marchi S, Cecchin E, Villalta D, et al. Relief of pruritus and decreases in plasma histamine concentrations during erythropoietin therapy in patients with uremia. N Engl J Med 1992; 326: 969-74
62. Giovannetti S, Bersotti G, Cupisti A, et al. Oral activated charcoal in patients with uremic pruritus. Nephron 1995; 70: 193-6
63. Pederson JA, Matter BJ, Czerwinski AW, et al. Relief of idiopathic generalized pruritus in dialysis patients treated with activated oral charcoal. Ann Intern Med 1980; 93: 446-8
64. Bousquet J, Rivory JP, Maheut M, et al. Double-blind placebo-controlled study of nicergoline in the treatment of pruritus in patients receiving maintenance hemodialysis. J Allergy Clin Immunol 1989; 83: 825-8
65. Ro YJ, Ha HC, Kim CG, et al. The effects of aromatherapy on pruritus in patients undergoing hemodialysis. Dermatol Nurs 2002; 14: 231-8
66. Stahle-Backdahl M. Stratum corneum hydration in patients undergoing maintenence haemodialysis. Acta Dermatol Venereol 1988; 68: 531-4
67. Garssen J, Vandebriel RJ, De Gruiji FR, et al. UVB exposure-induced systemic modulation of Th1- and Th2-mediated immune responses. Immunology 1999; 97: 506-14
68. Melzack R, Wall PD. Pain mechanism: a new theory. Science 1965; 150: 971-9
69. Albares MP, Betloch I, Guijarro J, et al. Severe pruritus in a hemodialysed patient: dramatic improtvement with granisetron. Br J Dermatol 2003; 148: 376-7
70. Andersen LW, Friedberg M, Lokkegaard N. Naloxone in treatment of uremic pruritus: a case history. Clin Nephrol 1984; 21: 355-6
71. Kaku H, Fujita Y, Yago H, et al. Study on pruritus in hemodialysis patients and the antipruritic effect of neurotropin: plasma levels of substance P, somatostatin, IgE, PTH and histamine. Nippon Jinzo Gakkai Shi 1990; 32: 319-26
72. Balaskas EV, Uldall RP. Erythropoietin treatment does not improve uremic pruritus. Perit Dial Int 1992; 12: 330-1
73. Tapia L, Cheigh JS, David DS, et al. Pruritus in dialysis patients treated with parenteral lidocaine. N Engl J Med 1977; 296: 261-2
74. Mettang T, Krumme B, Bohler J, et al. Pentoxifylline as treatment for uraemic pruritus: an addition to the weak armentarium for a common clinical symptom? Neph Dial Transpl 2007; 22: 2727-8
75. Cavalcanti AM, Rocha LM, Carillo R, et al. Effect of homeopathic treatment on pruritus of haemodialysis patients: a randomised placebo-controlled double-blind trial. Homeopathy 2003; 92: 177-81
76. Dawn AG, Yosipovitch G. Butorphanol for treatment of intractable pruritus. J Am Acad Dermatol 2006; 54: 527-31
77. Patel TS, Freedman BI, Yosipovitch G. An update on pruritus associated with CKD. Am J Kidney Dis 2007; 50: 11-20