title: Use of pregabalin in the management of chronic uremic pruritus.
abstract: BACKGROUND
  Uremic pruritus (UP) affects many patients suffering from chronic kidney disease (CKD) and has a negative impact on quality of life and survival. It has become increasingly evident that central transmission and sensitization processes similar to those observed in chronic pain are important mechanisms of pruritus.
  
  
  OBJECTIVE
  To test the potential role of pregabalin in reducing the intensity of UP in CKD patients.
  
  
  METHODS
  We prospectively collected data on CKD patients who suffered from severe intractable pruritus. Patients were asked to record the intensity of pruritus on a visual analogue scale.
  
  
  RESULTS
  Twelve patients were studied. The average pretreatment pruritus score was 9.7 ± 0.9 and decreased to 3.7 ± 2.35, 3.2 ± 1.75, and 3 ± 1.5 after one, four, and 24 weeks of treatment, respectively (P < 0.05). The positive effect of pregabalin was demonstrated during the first week of therapy in six patients. Most patients required 25mg a day. Pregabalin was well tolerated, with somnolence and dizziness developing in two patients.
  
  
  CONCLUSIONS
  We demonstrated dramatic improvement of long-standing UP after the initiation of pregabalin. We suggest that pregabalin can be used safely in CKD but careful titration of the dose is required to obtain an optimal response and minimize the possible adverse effects.
authors: Division of Adult Nephrology, Shaare Zedek Medical Center, Jerusalem, Israel. lshavit@szmc.org.il
authors: Linda
authors: L
authors: Shavit
authors: Tal
authors: T
authors: Grenader
authors: Meyer
authors: M
authors: Lifschitz
authors: Itzchak
authors: I
authors: Slotki
mesh_terms: D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D000069583:Pregabalin; D011537:Pruritus / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome; D014511:Uremia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D000927:Anticonvulsants; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid