Objectives:Uremic pruritus is a common problem in hemodialysis patients. Several treatments have been used for decreasing itching in these patients. Gabapentin and ketotifen are two drugs used for treating uremic patients. The aim of this study was to compare gabapentin and ketotifen in treatment of uremic pruritus in hemodialysis patients.Methods:In this double-blind randomized clinical trial, 52 hemodialysis patients with uremic pruritus referred to 5azarTeaching Hospital in Gorgan in 2013 were studied. Patients were randomly assigned to two groups of 26 subjects (groups G and K). In group G, patients treated with gabapentin capsules 100 mg daily for 2 weeks, and in Group K, patients treated with ketotifen 1 mg twice daily for 2 weeks. Before and at the end of study, pruritus severity was determined based on Shiratori’s severity scores. Collected data were analyzed by SPSS-21 statistical software.Results:There was no significant different between two groups in the age and sex. After two weeks of treatment, severity of pruritus was significantly reduced in both groups (88.4% in group G vs. 76.9% in group K). Gabapentin compared with ketotifen had a better effect on improving itching in the age group of 30-60 years and in males. 5 patients (19.2%) in both groups suffered from drowsiness and dizziness, but no serious side effects were observed.Conclusions:The results showed that gabapentin and ketotifen significantly improved pruritus in hemodialysis patients, and no significant difference was observed between two groups.
Introduction: Selenium (Se) is a rare element with well-demonstrated anti-oxidative effects that acts as an enzyme co-factor in physiological interactions. Low plasma Se level and malnutrition in hemodialysis (HD) patients could increase the risk of morbidity and mortality among these patients. Moreover, Se deficiency leads to oxidative stress and inflammatory response. Therefore, this study aimed to determine the association of plasma Se levels with malnutrition and inflammatory markers in HD patients. Materials and Methods: This cross-sectional study included 88 patients undergoing routine HD at dialysis unit of 5 th Azar Hospital in Gorgan, northeastern Iran. In addition, 88 healthy individuals were selected from the patients' families as controls. Level of Se, C-reactive protein (CRP), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG) and albumin were measured in the patients and controls by the atomic absorption method. Se levels were categorized into two groups of "over half-normalized" and "under half-normalized" for further analysis. Results: Hyposeleniemia was found in two patients (2.3%). The mean level of Se in HD patients was lower than in the healthy controls (P< 0.001). Among all HD subjects, 30.3% had under half-normalized Se level. In addition, 79.5% of HD patients were well nourished and 20.5% were moderately malnourished. There was no statistically significant difference between the mean level of Se in the malnourished and well-nourished subjects. Total mean level of HDL, LDL, TG and CRP had not significant correlation with plasma Se levels. There was a significant positive correlation between the mean plasma albumin and Se levels in the HD patients (P<0.05). Conclusions: The mean plasma Se level of HD patients in this area is in the normal range. There is no association between plasma Se level and malnutrition. Based on our findings, hyposelenemia is not a problem in HD patients in the Golestan Province.
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