Comparison of high-flux hemodialysis with hemodialysis filtration in treatment of uraemic pruritus: a randomized controlled trial

Jiang, Xia; Ji, Fen; Chen, Zhiwei; Qiao-lin, Huang

doi:10.1007/s11255-016-1364-2

Cited by 35 publications

(30 citation statements)

References 36 publications

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“…Five studies (total n 5 312) compared the effects of hemodialysis prescription modification on uremic pruritus. 24,27,57,61,64 All measured pruritus using a visual analogue scale, 4 were parallel-arm studies, and 1 was a crossover study. Two studies examined the effects of high-flux hemodialysis.…”

Section: Trials Of Hemodialysis Prescription Modificationmentioning

confidence: 99%

“…Two studies examined the effects of high-flux hemodialysis. 57,61 One compared the effects of using high-flux hemodialysis against hemodialysis filtration, 61 whereas the other compared it to a low-flux hemodialysis control. 57 Both determined that high-flux hemodialysis was significantly better in improving pruritus intensity.…”

Section: Trials Of Hemodialysis Prescription Modificationmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of Uremic Pruritus: A Systematic Review

Simonsen

Komenda

Lerner

et al. 2017

American Journal of Kidney Diseases

191

154

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Section: Trials Of Hemodialysis Prescription Modificationmentioning

confidence: 99%

Section: Trials Of Hemodialysis Prescription Modificationmentioning

confidence: 99%

Treatment of Uremic Pruritus: A Systematic Review

Simonsen

Komenda

Lerner

et al. 2017

American Journal of Kidney Diseases

191

154

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show abstract

“…109 In addition, an RCT has shown that high-flux haemodialysis is more effective in treating uraemic pruritus than haemodialysis filtration. 110 Secondary and tertiary hyperparathyroidism often accompany ESRD and may contribute to pruritus (see section 7.5).…”

Section: Uraemic Pruritusmentioning

confidence: 99%

British Association of Dermatologists’ guidelines for the investigation and management of generalized pruritus in adults without an underlying dermatosis, 2018

Millington¹,

Collins²,

Lovell³

et al. 2018

Br J Dermatol

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SummaryPruritus (or itch) is a common and distressing symptom of many skin diseases, systemic illnesses and psychological disorders. Itch is perhaps the commonest presenting symptom of skin disorders. In any two week period, 8 to 9% of the population suffer from significant pruritus. The focus of this guideline is not itchy rashes, but rather the situation where itch is present without rash. The guidelines also do not cover itch in children, in pregnancy, nor do they detail the science of the cause of itch. The study group consist mostly of dermatologists (skin specialists) from a number of hospitals in the U.K., but a number of other hospital doctors, a nurse and a general practitioner (GP) are also part of the team. There may be an underlying cause of pruritus, such as blood disorders, iron deficiency or excess, kidney problems, liver problems, cancer, infections, medications, behavioural factors, dry skin or any combination of these with old age. This can be significant in 20 to 30% of cases of itchy skin without rash. There remain a small number of individuals with itch and no apparent underlying cause or rash. It is always important to look for an underlying causative condition, as the most effective management of pruritus without rash depends on the treatment of any underlying disease. The management of itch appears to be very situation specific, even if the underlying cause cannot be treated. The management of true pruritus of unknown cause is different again.

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“…Use of high-flux polyacrylonitrile membrane has been reported to alleviate the severity of pruritus [43]. Hemodialysis with the target of Kt/V ≥ 1.5 (K = dialyzer clearance of urea, t = dialysis time, V = volume of distribution of urea, approximately equal to patient’s total body water) [44], as well as the use of high-flux dialyzer, may play a role in reducing the severity of uremic pruritus [44–46]. A search of published literature found that other factors that were found to be associated with CKD-aP were elevated blood urea nitrogen (BUN) [38, 47, 48]; crystal deposition of calcium and phosphate on skin (due to hypercalcemia and hyperphosphatemia) [49]; high aluminum level [50]; secondary hyperparathyroidism [47]; erythropoietin deficiency, high ferritin level, lower transferrin [30] and xerosis [51].…”

Section: Discussionmentioning

confidence: 99%

Sleep disturbance among Malaysian patients with end-stage renal disease with pruritus

et al. 2019

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BackgroundChronic kidney disease-associated pruritus (CKD-aP) is a well-recognized, frequent and compromising complication among patients on hemodialysis. Despite advancement in basic medical sciences, CKD-aP is still a major complication and a challenge for both physicians and patients to manage. The aim of this study was to estimate the prevalence of CKD-aP among hemodialysis patients in Malaysia, to determine the impact of CKD-aP on sleep quality and any factors associated with CKD-aP.MethodA multi-centered, cross-sectional study design was conducted from February 2017 to September 2017 at a tertiary hospital and its affiliated dialysis centers, in Kuala Lumpur, Malaysia. Included were patients > 18 years of age who were undergoing hemodialysis and could understand Malay. Participants were asked to fill the Malay 5D-itch scale and the Malay Pittsburgh sleep quality index (PSQI) upon recruitment.ResultsA total of 334/334 patients were recruited (response rate = 100%). The majority were male (59.6%) and Chinese (61.7%). A total of 61.3% had pruritus, of which most patients (63.4%) reported that their pruritus was mild. More than half (54.1%) reported that they slept > 6 h, and 93.2% experienced no sleep disturbances during the night. However; the overall PSQI median score [IQR] was 6.0 [5.0–9.0]. No significant association was found between demographic and clinical characteristics of patients with the severity of pruritus. Patients with moderate to severe pruritus were found to be 5.47 times more likely to experience poor sleep quality as compared to patients with mild or no pruritus.ConclusionIn Malaysia, the prevalence of CKD-aP was 61.3%, of which the majority reported that their pruritus was mild. Patients with moderate to severe pruritus were found to be 5.47 times more likely to experience poor sleep quality as compared to patients with mild or no pruritus.

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Comparison of high-flux hemodialysis with hemodialysis filtration in treatment of uraemic pruritus: a randomized controlled trial

Abstract: Our results demonstrate that HFHD has a better efficacy in the treatment of UP than HDF. HFHD has an exactly therapeutical efficacy in the UP associated with the inhibition of microinflammation state in dialysis patients.

Cited by 35 publications

References 36 publications

Treatment of Uremic Pruritus: A Systematic Review

Treatment of Uremic Pruritus: A Systematic Review

British Association of Dermatologists’ guidelines for the investigation and management of generalized pruritus in adults without an underlying dermatosis, 2018

Sleep disturbance among Malaysian patients with end-stage renal disease with pruritus

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