Pruritus, or as normal people call it, itching, is a common problem that afflicts patients with kidney failure ordialysis patients.It is one of those complications of advanced kidney disease that is hard to understand and perhaps harder to treat.
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How Common Is Itching In Dialysis Patients?
Why It Happens
This is not completely understood. Here are a few possibilities that we know of:
Symptoms
Well, you itch. But here are a few specific points:
Does It Affect Every Dialysis Patient?
Not necessarily. However, there are patients in whom certain risk factors have been identified. This is not a complete list since this is an active area of research:
Treatment
Identifying the underlying risk factor that might be a cause is the really the first step. If the patient who is not being adequately dialyzed or is missing treatments complains of itching, then the initial “treatment” would probably beprescribing an optimal dose of dialysis, rather than starting the patient on any specific medication for itching. One of the ways of increasing the dose of dialysis is to increase the duration of the treatment. This, however, may or may not be an acceptable option to a patient. Other interventions that can be tried to make sure patients are getting an efficient treatment is to increase their blood flow rates during the treatment, or making sure that they have a good dialysis access where ideally no recirculation is going on.
Finally, if all this fails, we often have to turn to medications. These could include anantihistaminelike Benadryl or diphenhydramine, or another medication which is similar called hydroxyzine. These medications will tend to be sedating and may not work in all cases. Loratadine is a non-sedating alternative.
Other medications that have been tried include gabapentin, pregabalin, and antidepressants including sertraline. For patients who get no relief even with these drugs, phototherapy with ultraviolet B light might help.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Combs SA, Teixeira JP, Germain MJ.Pruritus in kidney disease.Semin Nephrol. 2015;35(4):383-391. doi:10.1016/j.semnephrol.2015.06.009Ozen N, Cinar FI, Askin D, Mut D.Uremic pruritus and associated factors in hemodialysis patients: A multi-center study.Kidney Res Clin Pract. 2018 Jun;37(2):138-147. doi:10.23876/j.krcp.2018.37.2.138Akchurin OM, Kaskel F.Update on inflammation in chronic kidney disease.Blood Purif. 2015;39(1-3):84-92. doi:10.1159/000368940Arzhan S, Roumelioti ME, Unruh ML.Itch and ache on dialysis: new approaches to manage uremic pruritus and restless legs.Blood Purif. 2020;49(1-2):222-227. doi:10.1159/000504081Swarna SS, Aziz K, Zubair T, Qadir N, Khan M.Pruritus associated with chronic kidney disease: a comprehensive literature review.Cureus. 2019;11(7):e5256. doi:10.7759/cureus.5256Asghar MS, Avinash F, Singh M, et al.Associated factors with uremic pruritus in chronic hemodialysis patients: a single-center observational study.Cureus. 2021;13(8):e17559. doi:10.7759/cureus.17559Shirazian S, Aina O, Park Y, et al.Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges.Int J Nephrol Renovasc Dis. 2017;10:11-26. doi:10.2147/IJNRD.S108045
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Combs SA, Teixeira JP, Germain MJ.Pruritus in kidney disease.Semin Nephrol. 2015;35(4):383-391. doi:10.1016/j.semnephrol.2015.06.009Ozen N, Cinar FI, Askin D, Mut D.Uremic pruritus and associated factors in hemodialysis patients: A multi-center study.Kidney Res Clin Pract. 2018 Jun;37(2):138-147. doi:10.23876/j.krcp.2018.37.2.138Akchurin OM, Kaskel F.Update on inflammation in chronic kidney disease.Blood Purif. 2015;39(1-3):84-92. doi:10.1159/000368940Arzhan S, Roumelioti ME, Unruh ML.Itch and ache on dialysis: new approaches to manage uremic pruritus and restless legs.Blood Purif. 2020;49(1-2):222-227. doi:10.1159/000504081Swarna SS, Aziz K, Zubair T, Qadir N, Khan M.Pruritus associated with chronic kidney disease: a comprehensive literature review.Cureus. 2019;11(7):e5256. doi:10.7759/cureus.5256Asghar MS, Avinash F, Singh M, et al.Associated factors with uremic pruritus in chronic hemodialysis patients: a single-center observational study.Cureus. 2021;13(8):e17559. doi:10.7759/cureus.17559Shirazian S, Aina O, Park Y, et al.Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges.Int J Nephrol Renovasc Dis. 2017;10:11-26. doi:10.2147/IJNRD.S108045
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Combs SA, Teixeira JP, Germain MJ.Pruritus in kidney disease.Semin Nephrol. 2015;35(4):383-391. doi:10.1016/j.semnephrol.2015.06.009Ozen N, Cinar FI, Askin D, Mut D.Uremic pruritus and associated factors in hemodialysis patients: A multi-center study.Kidney Res Clin Pract. 2018 Jun;37(2):138-147. doi:10.23876/j.krcp.2018.37.2.138Akchurin OM, Kaskel F.Update on inflammation in chronic kidney disease.Blood Purif. 2015;39(1-3):84-92. doi:10.1159/000368940Arzhan S, Roumelioti ME, Unruh ML.Itch and ache on dialysis: new approaches to manage uremic pruritus and restless legs.Blood Purif. 2020;49(1-2):222-227. doi:10.1159/000504081Swarna SS, Aziz K, Zubair T, Qadir N, Khan M.Pruritus associated with chronic kidney disease: a comprehensive literature review.Cureus. 2019;11(7):e5256. doi:10.7759/cureus.5256Asghar MS, Avinash F, Singh M, et al.Associated factors with uremic pruritus in chronic hemodialysis patients: a single-center observational study.Cureus. 2021;13(8):e17559. doi:10.7759/cureus.17559Shirazian S, Aina O, Park Y, et al.Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges.Int J Nephrol Renovasc Dis. 2017;10:11-26. doi:10.2147/IJNRD.S108045
Combs SA, Teixeira JP, Germain MJ.Pruritus in kidney disease.Semin Nephrol. 2015;35(4):383-391. doi:10.1016/j.semnephrol.2015.06.009
Ozen N, Cinar FI, Askin D, Mut D.Uremic pruritus and associated factors in hemodialysis patients: A multi-center study.Kidney Res Clin Pract. 2018 Jun;37(2):138-147. doi:10.23876/j.krcp.2018.37.2.138
Akchurin OM, Kaskel F.Update on inflammation in chronic kidney disease.Blood Purif. 2015;39(1-3):84-92. doi:10.1159/000368940
Arzhan S, Roumelioti ME, Unruh ML.Itch and ache on dialysis: new approaches to manage uremic pruritus and restless legs.Blood Purif. 2020;49(1-2):222-227. doi:10.1159/000504081
Swarna SS, Aziz K, Zubair T, Qadir N, Khan M.Pruritus associated with chronic kidney disease: a comprehensive literature review.Cureus. 2019;11(7):e5256. doi:10.7759/cureus.5256
Asghar MS, Avinash F, Singh M, et al.Associated factors with uremic pruritus in chronic hemodialysis patients: a single-center observational study.Cureus. 2021;13(8):e17559. doi:10.7759/cureus.17559
Shirazian S, Aina O, Park Y, et al.Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges.Int J Nephrol Renovasc Dis. 2017;10:11-26. doi:10.2147/IJNRD.S108045
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