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Pruritus Associated With Chronic Kidney Disease: A Comprehensive Literature Review

The prevalence of pruritus in chronic kidney disease (CKD) patients has varied over the years, and some studies suggest the prevalence may be coming down with more effective dialysis. Chronic kidney disease-associated pruritus (CKD-aP), previously called uremic pruritus, is a distressing symptom exp...

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Autores principales: Swarna, Sanzida S, Aziz, Kashif, Zubair, Tayyaba, Qadir, Nida, Khan, Mehreen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6760874/
https://www.ncbi.nlm.nih.gov/pubmed/31572641
http://dx.doi.org/10.7759/cureus.5256
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author Swarna, Sanzida S
Aziz, Kashif
Zubair, Tayyaba
Qadir, Nida
Khan, Mehreen
author_facet Swarna, Sanzida S
Aziz, Kashif
Zubair, Tayyaba
Qadir, Nida
Khan, Mehreen
author_sort Swarna, Sanzida S
collection PubMed
description The prevalence of pruritus in chronic kidney disease (CKD) patients has varied over the years, and some studies suggest the prevalence may be coming down with more effective dialysis. Chronic kidney disease-associated pruritus (CKD-aP), previously called uremic pruritus, is a distressing symptom experienced by patients with mainly advanced chronic kidney disease. CKD-aP is associated with poor quality of life, depression, anxiety, sleep disturbance, and increased mortality. The incidence of CKD-aP is decreasing given improvements in dialysis treatments, but approximately 40% of patients with end-stage renal disease experience CKD-aP. While the pathogenesis of CKD-aP is not well understood, the interaction between non-myelinated C fibers and dermal mast cells plays an important role in precipitation and sensory stimulation. Other causes of CKD-aP include metabolic abnormalities such as abnormal serum calcium, parathyroid, and phosphate levels; an imbalance in opiate receptors is also an important factor. CKD-aP usually presents as large symmetric reddened areas of skin, often at night. Managing CKD-aP is a challenge. Research in this area is difficult because most studies are not comparable given their small group samples, study designs, and lack of standardized study measures. The most commonly used treatment is a combination of narrow-band ultraviolet B phototherapy and a μ-opioid receptor antagonist such as naltrexone.
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spelling pubmed-67608742019-09-30 Pruritus Associated With Chronic Kidney Disease: A Comprehensive Literature Review Swarna, Sanzida S Aziz, Kashif Zubair, Tayyaba Qadir, Nida Khan, Mehreen Cureus Dermatology The prevalence of pruritus in chronic kidney disease (CKD) patients has varied over the years, and some studies suggest the prevalence may be coming down with more effective dialysis. Chronic kidney disease-associated pruritus (CKD-aP), previously called uremic pruritus, is a distressing symptom experienced by patients with mainly advanced chronic kidney disease. CKD-aP is associated with poor quality of life, depression, anxiety, sleep disturbance, and increased mortality. The incidence of CKD-aP is decreasing given improvements in dialysis treatments, but approximately 40% of patients with end-stage renal disease experience CKD-aP. While the pathogenesis of CKD-aP is not well understood, the interaction between non-myelinated C fibers and dermal mast cells plays an important role in precipitation and sensory stimulation. Other causes of CKD-aP include metabolic abnormalities such as abnormal serum calcium, parathyroid, and phosphate levels; an imbalance in opiate receptors is also an important factor. CKD-aP usually presents as large symmetric reddened areas of skin, often at night. Managing CKD-aP is a challenge. Research in this area is difficult because most studies are not comparable given their small group samples, study designs, and lack of standardized study measures. The most commonly used treatment is a combination of narrow-band ultraviolet B phototherapy and a μ-opioid receptor antagonist such as naltrexone. Cureus 2019-07-28 /pmc/articles/PMC6760874/ /pubmed/31572641 http://dx.doi.org/10.7759/cureus.5256 Text en Copyright © 2019, Swarna et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Dermatology
Swarna, Sanzida S
Aziz, Kashif
Zubair, Tayyaba
Qadir, Nida
Khan, Mehreen
Pruritus Associated With Chronic Kidney Disease: A Comprehensive Literature Review
title Pruritus Associated With Chronic Kidney Disease: A Comprehensive Literature Review
title_full Pruritus Associated With Chronic Kidney Disease: A Comprehensive Literature Review
title_fullStr Pruritus Associated With Chronic Kidney Disease: A Comprehensive Literature Review
title_full_unstemmed Pruritus Associated With Chronic Kidney Disease: A Comprehensive Literature Review
title_short Pruritus Associated With Chronic Kidney Disease: A Comprehensive Literature Review
title_sort pruritus associated with chronic kidney disease: a comprehensive literature review
topic Dermatology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6760874/
https://www.ncbi.nlm.nih.gov/pubmed/31572641
http://dx.doi.org/10.7759/cureus.5256
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