title: Pruritus in hemodialysis patients: the problem remains.
abstract: Pruritus is still one of the most common and disturbing symptoms of end-stage renal disease. The objective of this study is to analyze the prevalence of pruritus in hemodialysis patients and the possible factors implicated in its genesis. In a cross-sectional study, 101 patients on hemodialysis at our center were screened for pruritus. The relationship of various factors with pruritus was evaluated. Of the 101 patients included, 31(30.7%) had pruritus at the time of examination. Patients with pruritus were significantly older than those without pruritus (P=0.0027). Pruritus tended to be more prevalent in patients undergoing dialysis 3 times a week than in those undergoing daily dialysis, but the difference did not reach statistical significance (P=0.0854). Lower transferrin saturation levels were found in patients with pruritus than in those without pruritus (P=0.0144). C-reactive protein levels were significantly higher in patients with pruritus than in those without pruritus (P=0.0013). There was no significant difference between the groups in the levels of the other inflammatory biomarkers measured. However, there was a tendency toward a correlation between the levels of alpha-1-glycoprotein and the intensity of pruritus (P=0.0834). Our results suggest a possible relationship of the inflammatory response upregulation to pruritus. Additionally, there was a positive relationship between pruritus and iron deficiency, possibly associated with inflammatory elevation of hepcidin. A better understanding of the factors implicated in the genesis of pruritus related to end-stage renal disease is crucial in the development of more effective treatments for this symptom.
authors.affiliation: University of Sao Paulo School of Medicine, Brazil. natimelo@yahoo.com
authors.forename: Natalia C V
authors.initials: NC
authors.lastname: Melo
authors.forename: Rosilene M
authors.initials: RM
authors.lastname: Elias
authors.forename: Manuel Carlos M
authors.initials: MC
authors.lastname: Castro
authors.forename: Joao E
authors.initials: JE
authors.lastname: Romao
authors.forename: Hugo
authors.initials: H
authors.lastname: Abensur
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009961:Orosomucoid / Q000032:analysis; D015995:Prevalence; D011537:Pruritus / Q000453:epidemiology*; D006435:Renal Dialysis; D001613:beta 2-Microglobulin / Q000097:blood
chemical_list: D009961:Orosomucoid; D001613:beta 2-Microglobulin; D002097:C-Reactive Protein