title: Antipruritic effects of two different 5-HT3 receptor antagonists and an antihistamine in haemodialysis patients.
abstract: Pruritus is the most distressing symptom in haemodialysis (HD) patients. Its aetiology has not yet been delineated, and thus there are no good therapeutical options. Case reports and series attribute antipruritic potency to the serotonin receptor antagonists of the 5-HT3 type in renal pruritus. It was the aim of this study to investigate the antipruritic effect of two different 5-HT3 receptor antagonists and an antihistamine in 11 patients undergoing HD. Pruritus was induced by iontophoresis with serotonin and histamine and recorded before and after HD. These data were compared to those obtained after oral pretreatment with the 5-HT3 receptor antagonists tropisetron 5 mg and ondansetron 8 mg and the antihistamine cetirizine 10 mg. Ten healthy volunteers served as a control group. Vasocutaneous parameters (wheal and flare), skin temperature and alloknesis were also determined. Itching in HD patients and controls was not significantly diminished by oral pretreatment with the serotonin receptor antagonists. In controls, but not in HD patients, cetirizine significantly reduced itching, skin temperature and vasocutaneous parameters. Our data additionally demonstrate that there are no significant differences in vasocutaneous parameters, itching and alloknesis in HD patients before and after dialysis. We conclude that 5-HT3 receptor blockers such as tropisetron and ondansetron and the antihistamine cetirizine do not sufficiently reduce serotonin- and histamine-induced itching in haemodialyis patients.
authors.affiliation: Department of Dermatology and Venereology, Otto-von-Guericke-University, Magdeburg, Germany. elke.weisshaar@med.uni-heidelberg.de
authors.forename: Elke
authors.initials: E
authors.lastname: Weisshaar
authors.forename: Nadine
authors.initials: N
authors.lastname: Dunker
authors.forename: Friedrich-Wilhelm
authors.initials: FW
authors.lastname: Röhl
authors.forename: Harald
authors.initials: H
authors.lastname: Gollnick
mesh_terms: D000328:Adult; D000368:Aged; D000982:Antipruritics / Q000494:pharmacology / Q000627:therapeutic use*; D017332:Cetirizine / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D006632:Histamine / Q000494:pharmacology; D006634:Histamine H1 Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007211:Indoles / Q000494:pharmacology / Q000627:therapeutic use; D007478:Iontophoresis; D008297:Male; D008875:Middle Aged; D017294:Ondansetron / Q000494:pharmacology / Q000627:therapeutic use; D011537:Pruritus / Q000150:complications / Q000188:drug therapy*; D012018:Reflex / Q000187:drug effects; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000150:complications / Q000628:therapy; D012701:Serotonin / Q000494:pharmacology; D058831:Serotonin 5-HT3 Receptor Antagonists; D012702:Serotonin Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D012867:Skin / Q000187:drug effects / Q000473:pathology; D012881:Skin Temperature / Q000187:drug effects; D016896:Treatment Outcome; D000077526:Tropisetron
chemical_list: D000982:Antipruritics; D006634:Histamine H1 Antagonists; D007211:Indoles; D058831:Serotonin 5-HT3 Receptor Antagonists; D012702:Serotonin Antagonists; D012701:Serotonin; D017294:Ondansetron; D000077526:Tropisetron; D006632:Histamine; D017332:Cetirizine