Interleukin-2 serum levels are elevated in patients with uremic pruritus: a novel finding with practical implications

Fallahzadeh, Mohammad Kazem; Roozbeh, Jamshid; Geramizadeh, Bita; Namazi, Mohammad Reza

doi:10.1093/ndt/gfr053

Cited by 89 publications

(75 citation statements)

References 38 publications

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“…An association between pruritus and C-reactive protein was reported in two studies (28,29) as in this study. Another study showed an association between pruritus and IL-2 but not with Creactive protein or other cytokines (30).…”

Section: Discussionmentioning

confidence: 96%

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

Rayner¹,

Larkina²,

Mia³

et al. 2017

CJASN

160

205

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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: Discussionmentioning

confidence: 96%

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

Rayner¹,

Larkina²,

Mia³

et al. 2017

CJASN

160

205

View full text Add to dashboard Cite

show abstract

“…Considering that the highest severity of itching has been reported during hemodialysis (8); itching during hemodialysis may be due to inflammatory mediators such as IL-I, which is released in response to plasma C5a when exposed to the dialysis membrane. In skin biopsies of patients undergoing dialysis, a significant increase in mast cells has been reported, and it has been suggested that the stimulation and proliferation of mast cells and the release of its mediators, such as histamine, interleukin and proteases, will not be due to CRF, but rather due to the dialysis process (13).…”

Section: Contextmentioning

confidence: 99%

Non-Pharmacological Treatments of Pruritus in Hemodialysis Patients: A Review Study

Sabzevari

Khalili

Rad

2018

Jundishapur J Chronic Dis Care

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Context: Pruritus in hemodialysis patients is one of the most common disturbing symptoms in patients with chronic renal failure. Non-pharmacological treatments can be useful in reducing patients' pruritus, however, few reviews have been published in this regard. The aim of this study was to provide non-pharmacological treatments for hemodialysis patients.Evidence Acquisition: The review study was conducted by searching electronic databases and search engines since 1990 to October 2017. The articles were included in the study that examined the effects of non-pharmacological treatments on pruritus in hemodialysis patients.Results: A total of 13 studies on non-pharmacological treatments affecting pruritus were reviewed. These treatments included phototherapy, aromatherapy, high flux dialyzer, acupressure, and cold dialysis. A review of studies has shown that phototherapy is not effective in treating the hemodialysis patients' pruritus. High flux dialyzer had the most effect in reducing pruritus. Other nonpharmacological treatments such as aromatherapy, acupressure, and cold dialysis also had an effect on pruritus relief. Conclusion:Finally, it can be concluded that high flux dialyzer is an effective non-pharmacological way to control pruritus during hemodialysis. However, little studies have been done on therapies such as acupressure and cold dialysis. A repeat of these studies with a larger sample size are recommended.

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“…Interestingly, bradykinin potentiated the chemo-responsiveness of polymodal nociceptors to IL-2 [139] resulting in a bi-directional augmentation. Clinical relevance of IL-2 in pruritic disorders was also implicated since elevated IL-2 serum levels were reported in hemodialyzed patients with uremic pruritus compared to non-pruritic subjects [140]. Moreover, cutaneous overexpression of IL-4 in mice resulted in a AD-like pruritic inflammatory skin disease [141] and increased IL-6 like immunreactivity was reported in cutaneous nerve fibers of prurigo nodularis patients [142].…”

Section: Inflammatory Mediators As Peripheral Itch Sensitizersmentioning

confidence: 99%

TRP Channels and Pruritus

Tóth¹,

Bı́ró²

2013

TOPAINJ

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Itch (pruritus) is one of the most often seen sensory phenomena in clinical practice. Recent neurophysiological findings proposed the existence of a novel pruriceptive system which includes a multitude of pruritogenic (itch-inducing) peripheral mediators, itch-selective pruriceptors, sensory afferent networks, spinal cord neurons, and certain central nervous system regions. In this review, we first introduce major features of the pruriceptive system. We then focus on defining the roles of transient receptor potential (TRP) ion channels in skin-coupled itch and provide compelling evidence that certain thermosensitive TRP channels (especially TRPV1, TRPV3, TRPV4, and TRPA1) are indeed key players in pruritus pathogenesis. Finally, we propose TRP-centered future experimental directions towards the therapeutic targeting of TRP channels in the clinical management of itch.

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Interleukin-2 serum levels are elevated in patients with uremic pruritus: a novel finding with practical implications

Cited by 89 publications

References 38 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

Non-Pharmacological Treatments of Pruritus in Hemodialysis Patients: A Review Study

TRP Channels and Pruritus

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