Comparison of pregabalin with ondansetron in treatment of uraemic pruritus in dialysis patients: a prospective, randomized, double-blind study

Yue, Ji; Jiao, Shoufeng; Xiao, Yangfei; Ren, Wei; Zhao, Tengda; Meng, Jie

doi:10.1007/s11255-014-0795-x

Cited by 86 publications

(72 citation statements)

References 27 publications

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“…Pregabalin (n=67) reduced itch severity by 4.6 cm more than placebo (n=57) and also improved sleep quality and health-related quality of life (10). In a case series of 71 patients with severe pruritus, 85% were relieved of itching with gabapentin or pregabalin (11).…”

Section: Introductionmentioning

confidence: 99%

International Comparisons of Prevalence, Awareness, and Treatment of Pruritus in People on Hemodialysis

Rayner¹,

Larkina²,

Mia³

et al. 2017

CJASN

175

238

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Background and objectives Uremic pruritus in patients on hemodialysis is associated with depression, lower quality of life, and mortality. We studied the prevalence, awareness, and treatment of pruritus to assess how well this important condition is currently managed internationally.Design, setting, participants, & measurements Data from 35,452 patients on hemodialysis in up to 17 countries from the Dialysis Outcomes and Practice Patterns Study were analyzed to describe pruritus prevalence from 1996 to 2015. Data from 6256 patients and 268 medical directors in 17 countries in 2012-2015 were analyzed to describe predictors, effects, medical directors' awareness, and treatment of pruritus.Results Patients very much or extremely bothered by itching declined from 28% in 1996 to 18% in 2015. In 2012-2015, among patients nearly always or always bothered by itching, pruritus had a major effect on work and social life; 18% used no treatment for pruritus, and 17% did not report itching to health care staff. In total, 69% of medical directors underestimated the prevalence of pruritus in their unit. Managing high serum phosphorus and low Kt/V was ranked as the most important intervention, but no relationship was found between these factors and pruritus; 57% of medical directors used oral antihistamines for first-line chronic treatment of pruritus. Gabapentin was used by 45% as first-, second-, or third-line treatment. Nalfurafine was only used in Japan.Conclusions The prevalence of pruritus in people on hemodialysis is decreasing but remains underestimated. Large numbers of patients on hemodialysis with severe pruritus do not receive treatment. There is wide variation in the use of unlicensed medications for the treatment of pruritus. These data provide a benchmark for initiatives to improve the management of uremic pruritus.

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Section: Introductionmentioning

confidence: 99%

International Comparisons of Prevalence, Awareness, and Treatment of Pruritus in People on Hemodialysis

Rayner¹,

Larkina²,

Mia³

et al. 2017

CJASN

175

238

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“…98 A recent qualitative systematic review of 7 studies evaluating gabapentin (179 participants) supported a trial of gabapentin for the treatment of CKD-aP refractory to antihistamines and/or emollients. 97 Pregabalin, a medication similar to gabapentin, may also improve CKD-aP 37,99 and may be particularly useful when patients are not able to tolerate gabapentin. 1,100 In a randomized, crossover trial, 50 HD patients were assigned to gabapentin 300 mg or pregabalin 75 mg daily.…”

mentioning

confidence: 99%

Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges

Shirazian¹,

Aina²,

Park³

et al. 2017

IJNRD

103

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Chronic kidney disease-associated pruritus (CKD-aP) is a distressing, often overlooked condition in patients with CKD and end-stage renal disease. It affects ~40% of patients with end-stage renal disease and has been associated with poor quality of life, poor sleep, depression, and mortality. Prevalence estimates vary based on the instruments used to diagnose CKD-aP, and standardized diagnostic instruments are sorely needed. Treatment studies have often yielded conflicting results. This is likely related to studies that are limited by small sample size, flawed designs, and nonstandardized diagnostic instruments. Several large well-designed treatment trials have recently been completed and may soon influence CKD-aP management.

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“…However, HFHD had a better efficacy in the treatment of UP than HDF in dialysis patients. Traditional hemodialysis is usually used to clear blood small molecules including BUN and creatinine via the dispersion effect, but is unable to scavenge other large and medium molecular substance such as PTH and β2-MG [20]. Long term of hemodialysis may induce secondary hyperparathyroidism, metabolic disorders of calcium and phosphorus and accumulations of large and medium molecular substances, which leads to stubborn pruritus [20,26].…”

Section: Discussionmentioning

confidence: 99%

“…Visual Analogue Scale (VAS) and Modified Duo's VAG Scale were employed to evaluate the severity of pruritus [20]. The VAS was a valid and reliable tool to measure the general severity ranging from 0 to 10 (0 meant no pruritus, while 10 indicated worst pruritus).…”

Section: Measurement Of Pruritus Severitymentioning

confidence: 99%

Comparison of high-flux hemodialysis with hemodialysis filtration in treatment of uraemic pruritus: a randomized controlled trial

Jiang

Chen

et al. 2016

Int Urol Nephrol

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Comparison of pregabalin with ondansetron in treatment of uraemic pruritus in dialysis patients: a prospective, randomized, double-blind study

Abstract: Pregabalin is an effective alternative for treatment of uraemic pruritus. Ondansetron has negligible effect on uremic pruritus and is expensive. A larger sample size may be needed to demonstrate the effect of ondansetron in uraemic pruritus.

Cited by 86 publications

References 27 publications

International Comparisons of Prevalence, Awareness, and Treatment of Pruritus in People on Hemodialysis

International Comparisons of Prevalence, Awareness, and Treatment of Pruritus in People on Hemodialysis

Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges

Comparison of high-flux hemodialysis with hemodialysis filtration in treatment of uraemic pruritus: a randomized controlled trial

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