uraemic pruritus

Last edited 03/2021 and last reviewed 03/2021

Itch (uraemic pruritus) is a common symptom in people with endstage kidney disease (ESKD)

• affects 42% to 57% of people on dialysis

Despite its high prevalence, mechanisms driving uraemic itch remain poorly understood

• two common theories implicate hyperactive and disordered immune or opioid systems
  • roles have also been proposed for hyperparathyroidism, abnormal serum chemistry, mast cell hyperactivity, and dialysis technique

Management (1):

• evidence that gabapentinoids (gabapentin and pregabalin) show the greatest reduction in itch scores
• evidence for oral montelukast, turmeric, zinc sulfate, and topical capsaicin also showed an itch score reduction. However, these reductions
  were reported in small studies, and warrant further investigation

• Hercz D et al.Interventions for itch in people with advanced chronic kidney disease. Cochrane Database of Systematic Reviews 2020, Issue 12. Art. No.: CD011393. DOI: 10.1002/14651858.CD011393.pub2.