Regression of uraemic pruritus by cyclosporin treatment in a haemodialysis patient

Fusaro, Maria; Munaretto, G; Spinello, Michela; Gallieni, Maurizio

doi:10.1093/ndt/gfh131

Cited by 16 publications

(8 citation statements)

References 4 publications

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“…The second issue addressed refers to CyA neurotoxicity, but it is reversible after sustainment of treatment . Few reports, demonstrate good safety and tolerance of CyA in the treatment of uremic pruritus in HD patients …”

Section: Discussionmentioning

confidence: 99%

“…17 Few reports, demonstrate good safety and tolerance of CyA in the treatment of uremic pruritus in HD patients. 18 Individuals previously treated with puvasol, methotrexate or other immunosuppressive agents, UVB, coal tar, or radiation therapy, are at an increased risk of developing skin cancer when taking CyA. CyA is a potent immunosuppressant used to treat psoriasis 19 but treatment should be individualized according to the therapeutic needs of each patient.…”

Section: Discussionmentioning

confidence: 99%

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New‐onset psoriasis in a maintenance hemodialysis patient

Triga

Dousdampanis

Aggelakou-Vaitsi

et al. 2011

Hemodialysis International

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New-onset psoriasis is extremely rare in hemodialysis (HD) patients, and several trials of dialysis therapies (HD and peritoneal dialysis) in psoriasis have indicated remarkable improvement in skin lesions and well-being even in patients without renal impairment. We describe a patient who developed severe psoriasis despite undergoing chronic maintenance hemodialysis for 5 years and was treated successfully with oral cyclosporin A.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

New‐onset psoriasis in a maintenance hemodialysis patient

Triga

Dousdampanis

Aggelakou-Vaitsi

et al. 2011

Hemodialysis International

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“…This may have been because the number of CKD patients included in the study were small or the albumin level was likely dissociated in the skin and blood, similar to Ca 2+ [3] . The Ca 2+ is thought to be intimately involved in the mechanism of a number of these treatments, such as lowcalcium dialysis fluids [21] , parathyroidectomy [22] , antiallergy medications, immunosuppressants [23] , gabapentin [24] , nalfurafine hydrochloride [4] , topical vitamin D [25] , and capsaicin cream (in other words, TRPV1) [8] . With regard to itching and the increased extracellular concentrations of Ca 2+ , it may be that an increase in extracellular Ca 2+ leads to changes in the microenvironment of the C-fiber itch receptor.…”

Section: +mentioning

confidence: 99%

Total Calcium and Albumin Are Decreased in the Deeper Epidermis of Patients with Chronic Kidney Disease-Associated Pruritus

Momose¹,

Shiraiwa²,

Narita³

et al. 2017

Nephron

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Background/Aims: In our earlier studies, we reported high concentrations of intra- and extracellular calcium ions (Ca²⁺) in the deeper epidermis of patients with chronic kidney disease (CKD) and associated pruritus. To determine the cause of this phenomenon, we measured total calcium (TCa) concentrations in the deeper epidermis and performed immunostaining of epidermal albumin, which binds to Ca²⁺. Methods: This study included 45 patients with CKD-stage 5, which was defined as severely reduced kidney function (i.e., estimated glomerular filtration rate less than 15 mL/min or on dialysis). Subjects were divided into the pruritus group, consisting of patients with mild, moderate, or severe uremic pruritus, and the non-pruritus group, consisting of patients with no or slight pruritus. The particle-induced X-ray emission method was used to measure elements including TCa. Furthermore, we have immunostained epidermal albumin using anti-albumin antibodies and compared the results in the pruritus and non-pruritus groups. Results: The TCa concentration in the spinous layer of patients with CKD with CKD-associated pruritus was lower than in patients with CKD without pruritus (median [range], 395 [235-1,063] vs. 476 [342-1,243] μg/g). The intensity of epidermal albumin expression in the spinous layer was weaker in patients with CKD with CKD-associated pruritus than in those without. Conclusion: Patients with CKD with CKD-associated pruritus demonstrated higher Ca²⁺ concentrations but lower TCa concentrations than patients without CKD-associated pruritus. This could be in part due to low concentrations of epidermal albumin, which binds to Ca²⁺, in those with CKD-associated pruritus. These results clarify the pathophysiology of CKD-associated pruritus, providing a valuable foundation for the future development of treatments for this condition.

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“…Finally, symptomatic therapy consists in skin emollients, UVB light, gabapentin (56) and the k-opioid agonist nalfurafine (57). Regression of severe and refractory uremic pruritus by cyclosporine has also been observed, supporting the hypothesis of immune pathogenesis of uremic pruritus in some cases (58).…”

Section: Uremic Pruritusmentioning

confidence: 78%

Neurological complications of hemodialysis: state of the art

Rizzo

Frediani²,

Basile³

et al. 2011

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Neurological complications frequently affect chronic kidney disease patients. They are important causes of morbidity and mortality. We present a review of neurological complications affecting hemodialysis patients, focusing on classical and new aspects. Neurological complications can be classified as central or peripheral, but they also include other conditions such as muscle and autonomic disorders. Neurological complications in hemodialysis patients are often underdiagnosed and undertreated. Dialysis treatment can modify the clinical pattern and the course of neurological complications, but it may also directly induce some specific, dialysis-related complications. A strict collaboration between nephrologists, neurologists and other specialists can potentially improve prevention and management of these disorders and improve quality of life for hemodialysis patients.

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Regression of uraemic pruritus by cyclosporin treatment in a haemodialysis patient

Cited by 16 publications

References 4 publications

New‐onset psoriasis in a maintenance hemodialysis patient

New‐onset psoriasis in a maintenance hemodialysis patient

Total Calcium and Albumin Are Decreased in the Deeper Epidermis of Patients with Chronic Kidney Disease-Associated Pruritus

Neurological complications of hemodialysis: state of the art

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