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Dermatology Other
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my personal edition > dermatology other > news
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DGReview
Pruritus Common In Patients on Haemodialysis
A DGReview of :"Prevalence and characterization of uremic pruritus in patients undergoing hemodialysis: Uremic pruritus is still a major problem for patients with end-stage renal disease"
Journal of the American Academy of Dermatology
11/04/2003
By Emma Hitt, PhD
About two thirds of patients undergoing haemodialysis may develop prolonged, frequent, and intense uraemic pruritus at some point, according to new survey findings.
Few studies have evaluated the clinical characteristics of uraemic itch in patients with advanced end-stage renal disease. Inbar Zucker, MD, with the Rabin Medical Centre, Petach Tikva, Israel, and colleagues administered a detailed questionnaire to evaluate pruritus in 219 patients undergoing haemodialysis treatment in 3 dialysis units. They examined the relationship of the quality of dialysis and various factors and medical parameters to itch.
The researchers found that pruritus was common. Approximately 66% of the patients had pruritus at some point, and 48% were affected by it at the time of the study. However, the occurrence of pruritus was not associated with demographic or medical parameters, such as type of kidney disease, medical management, or dialysis efficacy.
Factors found to exacerbate pruritus included rest, heat, dry skin, and sweat, while factors found to reduce pruritus included activity, sleep, hot and cold shower, and cold.
Treatment with angiotensin inhibitors seemed to be more common among those with uraemia who had itch (P = .02) whereas furosemide was more commonly used among those who never itched (P = .002), they report.
"This study provides a detailed description of uremic pruritus with new data on its characteristics including affective and sensory dimensions and associated symptoms," the researchers conclude.
"Because of its long duration, frequency and high-intensity uremic pruritus is a very bothersome symptom with great potential to impair the patient's quality of life," Dr. Zucker and colleagues note. "That could be reflected in the large percentage of patients with sleep difficulties secondary to their pruritus, and in the finding that more than 40% of the patients had altered moods because of the pruritus," they add.
J Am Acad Dermatol 2003;49:5:842-846.
"Prevalence and characterization of uremic pruritus in patients undergoing hemodialysis: Uremic pruritus is still a major problem for patients with end-stage renal disease"
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