Is uremic pruritus still an important clinical problem in maintenance hemodialysis patients?

Heisig, Monika; Reich, Adam; Szepietowski, Jacek C.

doi:10.1111/jdv.13524

Cited by 14 publications

(16 citation statements)

References 9 publications

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“…Restoration of therapy ensued in pruritus disappearance. Our experience supports the role of paroxetine administered in a dose of 10‐20 mg in alleviating psychogenic pruritus in the elderly …”

Section: The Treatment Of Pruritussupporting

confidence: 78%

Can we use psychoactive drugs to treat pruritus?

Reszke

Szepietowski

2019

Experimental Dermatology

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Pruritus is a frequent complaint both in dermatology and general medicine. This burdensome symptom has a complex and multifactorial pathogenesis, with the key involvement of central nervous system in its development. Psychoactive drugs (psychopharmaceuticals) encompass several therapeutic groups utilized mainly in psychiatry. However, these drugs are occasionally used in dermatological practice and may contribute to alleviation of pruritus in a variety of cutaneous and extracutaneous disorders. This review article summarizes the role of H1‐antihistamines, antidepressants, antipsychotics and antiepileptics in managing pruritus.

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Section: The Treatment Of Pruritussupporting

confidence: 78%

Can we use psychoactive drugs to treat pruritus?

Reszke

Szepietowski

2019

Experimental Dermatology

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“…The mean AP intensity evaluated with VAS (4.8 ± 1.9 points) was lower in comparison with pruritus observed in common dermatoses, such as atopic dermatitis (7.9 ± 2.2 points) (13), chronic urticaria (7.5 ± 1.8 points) (24) or lichen planus (6.5 ± 2.7 points) (25). However, with regard to other internal diseases, such as uraemic pruritus (4.1 ± 2.0 points) (26) or diabetes mellitus (4.7 ± 2.8 points) (27), the severity of AP appears to be comparable. Considering the assessments conducted with 4-item Itch Questionnaire, in opposition to other diseases presenting similar symptoms, such as atopic dermatitis (14.0 ± 4.4 points) (13) or uraemic pruritus (8.2 ± 4.5 points) (15), the mean results for AP were somewhat lower (6.0 ± 2.9 points).…”

Section: Discussionmentioning

confidence: 89%

“…In opposition to common skin diseases, such as atopic dermatitis (85%) (19) or chronic urticaria (97%) (20), the frequency of pruritus in patients with PV is much lower. However, in other internal disorders, such as diabetes mellitus (8%) (21) or uraemic pruritus (25-52.6%) (22,23), itching occurs more rarely or equally with AP in PV. PV-associated pruritus puts an additional burden on patients with PV.…”

Section: Discussionmentioning

confidence: 99%

Aquagenic Pruritus in Polycythemia Vera: Clinical Characteristics

Lelonek¹,

Matusiak²,

Wróbel³

et al. 2018

Acta Derm Venerol

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Aquagenic pruritus is one of the main clinical features of polycythemia vera. The aim of this study was to analyse the clinical characteristics of aquagenic pruritus. The study group comprised 102 patients with molecularly confirmed polycythemia vera. Demographic data, data on disease history, polycythemia vera status and treatment modalities were collected. Moreover, various clinical features of aquagenic pruritus (including intensity, localization, quality, descriptors) and the most common factors responsible for its aggravation or alleviation were examined. Aquagenic pruritus was observed in 41.2% of individuals, mean duration 6.6 ± 8.6 years, and its onset was noticed in the majority of patients (52.4%) before the diagnosis of polycythemia vera. The mean intensity of aquagenic pruritus was 4.8 ± 1.9 points (visual analogue scale). One-third of patients with aquagenic pruritus avoided any contact with water. Antipruritic treatment was received only by 3 patients. Aquagenic pruritus seems to be an important, but frequently neglected, symptom in patients with polycythemia vera.

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“…Pruritus is one of the most distressing symptoms in chronic kidney disease (CKD) [2] also termed, "CKD associated pruritus" (CKD-P) [3]. Uremic pruritus is extremely common in patients undergoing hemodialysis [4,5]. For example, a recent study of 18,801 hemodialysis patients demonstrated that pruritus affected approximately 42% of all patients, and 15-49% of patients with chronic renal failure.…”

Section: Introductionmentioning

confidence: 99%

Skin Cutibacterium acnes Mediates Fermentation to Suppress the Calcium Phosphate-Induced Itching: A Butyric Acid Derivative with Potential for Uremic Pruritus

Keshari

Wang

Herr

et al. 2020

JCM

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Pruritus and inflammation associated with accumulation of calcium phosphate (CaP) under the skin are common problems among dialysis patients with chronic kidney disease (CKD). The role of skin commensal microbiota in the CaP-induced uremic pruritus remains uncharacterized. Skin Cutibacterium acnes (C. acnes) can solubilize CaP by the production of short-chain fatty acids (SCFAs), such as butyric acid, through glucose fermentation. Like butyric acid, the N-[2-(2-Butyrylamino-ethoxy)-ethyl]-butyramide (BA-NH-NH-BA), a butyric acid derivative, remarkably induced acetylation of histone H3 lysine 9 (AcH3K9) in keratinocytes. Topical application of fermenting C. acnes, butyric acid or BA-NH-NH-BA onto mouse skin effectively ameliorated CaP-induced skin itching, interleukin (IL)-6 up-regulation in keratinocytes, and extracellular signal-regulated kinase (ERK) 1/2 activation in dorsal root ganglia (DRG). Activation of ERK 1/2 by CaP was markedly reduced in IL-6 knockout mice. Genus Cutibacterium was detected in relatively low abundance in itchy skin of patients with CKD. Our results identify a role for the skin fermenting C. acnes in ameliorating CaP-induced activation of IL-6/p-ERK signaling and resulting skin inflammation. Furthermore, we provide evidence for the potential therapeutic efficacy of BA-NH-NH-BA as a postbiotic for the treatment of uremic pruritus.

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Is uremic pruritus still an important clinical problem in maintenance hemodialysis patients?

Cited by 14 publications

References 9 publications

Can we use psychoactive drugs to treat pruritus?

Can we use psychoactive drugs to treat pruritus?

Aquagenic Pruritus in Polycythemia Vera: Clinical Characteristics

Skin Cutibacterium acnes Mediates Fermentation to Suppress the Calcium Phosphate-Induced Itching: A Butyric Acid Derivative with Potential for Uremic Pruritus

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