Uremic Pruritus in Haemodialysis Patients

Background. Uremic pruritus is common complaint among dialysis patients. The prevalence of renal itching in patients on dialysis is approximately 30%, but its treatment is often ineffective. The etiology of uremic pruritus remains unclear. The aim of this study was to evaluate the prevalence and severity of pruritus, and to correlate its presence and intensity with relevant clinical and laboratory parameters. Methods. Seventy-seven patients on maintenance haemodialysis were enrolled in the study. The mean age of patients was 55,78 ± 14,11 and duration of dialysis was 5,27 ± 3,80 years. Itch intensity was scored as mild, moderate and severe. One interviewer surveyed seventy-seven patients over three-day period. Some clinical and laboratory parameters were evaluated (age, sex, duration of dialysis, etiology of chronic renal failure (CRF), hematocrit, calcium, phosphorus, parathyroid hormone (PTH), Kt/V, calcium & phosphorus product). Ten patients with refractory pruritus were treated with UVB irradiation for two months, three times weekly, two minutes per each treatment. Results. Forty-five of seventy seven patients experienced itching (58,44%). The intensity of itching was mild, moderate and severe, in 42,22%, 40,0%, 17,78% of patients, respectively. In 19 patients (42,22%) pruritus intensified during and after dialysis. There was no significant difference in the serum levels of calcium, phosphorus, PTH, hematocrit, albumin and duration of haemodialysis. However, there was a significant difference in value of Kt/V in patients with pruritus (p<0,01) which has been lower, as well as the product of Ca and P04 (p <0,05). Conclusions. Our study has shown that increasing the dose of dialysis (Kt/V) leads to an improvement in uremic pruritus. Also UVB irradiation of the body, 1-2 minutes twice a week in ten patients resulted in long-lasting remission of the pruritus.