End-Stage Renal Disease Chronic Itch and Its Management

• Published in: Dermatologic clinics Vol. 36; no. 3; pp. 277 - 292
• Main Authors: Reszke, Radomir, MD, Szepietowski, Jacek C., MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2018
• Subjects: Amines - therapeutic use; Analgesics, Opioid - therapeutic use; Anticonvulsants - therapeutic use; Antipruritics - therapeutic use; Chronic Disease; Chronic itch; Chronic kidney disease; Cyclohexanecarboxylic Acids - therapeutic use; Dermatology; Emollients - therapeutic use; Epidemiology; gamma-Aminobutyric Acid - therapeutic use; Humans; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - physiopathology; Kidney Failure, Chronic - therapy; Nalbuphine - therapeutic use; Narcotic Antagonists - therapeutic use; Pathogenesis; Pregabalin - therapeutic use; Pruritus - etiology; Pruritus - physiopathology; Pruritus - therapy; Quality of Life; Renal Dialysis; Severity of Illness Index; Treatment; Ultraviolet Therapy; Chronic itch; Chronic kidney disease; Treatment; Pathogenesis; Epidemiology; Quality of life
• ISSN: 0733-8635; 1558-0520
• DOI: 10.1016/j.det.2018.02.007

End-stage renal disease chronic itch is a frequent symptom that bothers patients with advanced stages of chronic kidney disease. The pathogenesis of the chronic itch symptom is complex and not yet fully understood and includes many metabolic, immunologic, and neurogenic factors. A significant burden of the disease results in decreased quality of life with sleep impairment, depressive symptoms, and increased mortality of affected individuals. No treatment of choice is available; topical therapy (emollients), phototherapy (UV-B), and systemic therapy (antiepileptics, opioid agonists, and antagonists) provide significant relief in varying percentages of patients.