Effect of Auricular Acupressure on Uremic Pruritus in Patients Receiving Hemodialysis Treatment: A Randomized Controlled Trial

Abstract

Background. Uremic pruritus (UP) is a common symptom in patients undergoing maintenance hemodialysis for end-stage renal disease (ESRD). Objective. To determine the clinical efficacy of auricular acupressure therapy on pruritus in hemodialysis patients and to explore possible underlying mechanisms. Methods. Patients receiving maintenance hemodialysis at a referral medical center were recruited and assigned to intervention (n = 32) and control (n = 30) groups. The intervention group underwent auricular acupressure treatment three times a week for six weeks. Auricular acupressure was not applied to patients in the control group. However, tape without Vaccaria seeds was applied to the same six auricular acupoints as the intervention group. Pruritus scores were assessed using VAS scores, and enzyme-linked immunosorbent assays (ELISA) were used to measure levels of other possible contributory biochemical factors. Results. There was a significant difference in mean VAS scores between the postintervention and control groups during follow-up (3.844 ± 1.687 versus 5.567 ± 2.285, F = 22.32, P < 0.0001). Compared to the control group, serum histamine levels in the postintervention group at the six-week follow-up had decreased significantly (F = 5.01, P = 0.0290). Conclusion. Our findings suggest that auricular acupressure may be a useful treatment in the multidisciplinary management of UP in ESRD patients.

Effect of Aromatherapy on Uremic Pruritus among Patients Undergoing Hemodialysis

“…Moreover [28] reported another regimen for duration of hemodialysis session as where high percentage of hemodialysis patients spend 1.5-2.75 hours six times per week. Another study done by [29] who reported that all participants enrolled in their study were undergoing hemodialysis and spent four hours for three times per week. In relation to frequency of hemodialysis session per week the current study finding reported that approximately all of the study participants adhere to hemodialysis session three times per week.…”

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

“…Auricular acupressure may be beneficial in uraemic pruritus as reported in an unblinded, placebo-controlled trial. 281 Two uncontrolled studies suggest the benefits of aromatherapy in uraemic pruritus. 282,283 Treatments in other uncontrolled studies that may show benefit in uraemic pruritus include Sericin cream, derived from silkworms, 284 topical turmeric 285 and oral omega-3 fatty acid supplements.…”

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

“…Acupressure combines massage and pressure to specific points, along a defined meridian, similar to those used for acupuncture. Auricular acupressure may be beneficial in uraemic pruritus as reported in an unblinded, placebo‐controlled trial …”