Efficacy of topical cromolyn sodium 4% on pruritus in uremic nephrogenic patients: A randomized double-blind study in 60 patients

Introduction: The epidemiology of pulmonary hypertension (PHT) among long-term hemodialysis patients has been described in relatively small studies in Iran. Objectives: The purpose of this study was to evaluate the prevalence of PHT and its relationship among end-stage renal disease (ESRD) patients undergoing long-term hemodialysis (HD). Patients and Methods: In a cross-sectional study, patients with ESRD treated with HD for at least 3 months in the Imam hospital enrolled for the study. PHT was defined as an estimated systolic pulmonary artery pressure (PAP) equal to or higher than 25 mm Hg using echocardiograms performed by cardiologist. Results: A total of 69 HD patients were included in the investigation. The mean of age of our patients was 52.6±15.3 years. The mean duration of HD was 39±36 months. The mean ejection fraction was 45±7%. The prevalence of PHT was 62.3%. These patients were more likely to have lower ejection fraction. The PHT was more common among female HD patients. We did not find any association between PHT and cause of ESRD, duration of HD, anemia and serum calcium, phosphor and parathyroid hormone levels. Conclusion: Our findings show that PHT is a common problem among ESRD patients undergoing maintenance HD and it is strongly associated with heart failure. It is necessary to screen this disorder among these patients.

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“…The ESRD was defined as irreversible and advance loss of kidney function due to any etiology requiring long term RRT with HD (5-9). …”

Section: Methodsmentioning

confidence: 99%

Pulmonary hypertension among patients undergoing hemodialysis

et al. 2016

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“…Mast cell stabilizers, such as cromolyn sodium and nicotinamide, work by preventing the degranulation of mast cells. Cromolyn sodium has been compared to placebo in two studies and showed a significant reduction in pruritus intensity . Nicotinamide was studied in one trial and was not found to be more effective than placebo .…”

Section: Nonspecificmentioning

confidence: 99%

Dermatologic manifestations in end stage renal disease

Blaha

Nigwekar

Combs

et al. 2018

Hemodialysis International

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Skin manifestations are commonly seen in end stage renal disease (ESRD). Skin involvement in this population can be extensive and dramatically worsen quality of life. Close observation of the skin and nails of ESRD patients by clinicians allows for timely diagnosis and treatment, which ultimately improves quality of life and reduces mortality. In this article we focus on the cutaneous changes most commonly seen in ESRD patients. PubMed/Medline database search was done for published literature on skin manifestations in ESRD patients. All the available literature was reviewed and relevant articles were used to discuss about clinical features, pathogenesis, histology and treatment of each skin disorder in ESRD patients. Most commonly encountered skin manifestations in patients with ESRD are pruritus, xerosis, pigmentation changes, nail changes, perforating disorders, calcifying disorders, bullous dermatoses and nephrogenic systemic fibrosis. Skin manifestations in ESRD can be difficult to treat and multiple comorbidities in this patient population can exacerbate these disorders. Many of the treatment options are experimental with evidence largely derived from the case reports and small clinical trials. More large‐scale trials are needed to firmly establish evidence based treatment guidelines. Prompt evaluation and management of these disorders improve morbidity and quality of life in ESRD patients.

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“…81 In a subsequent RCT of 60 HD patients, twice daily cromolyn sodium cream 4% significantly reduced pruritus severity compared to placebo over 4 weeks. 82 In a double-blind, RCT of 40 HD patients, zinc sulfate, a medication shown to prevent histamine release from mast cells, 83 given for 2 months led to a significant improvement in CKD-aP compared to placebo. 84 However, a subsequent RCT of 36 patients did not confirm these findings.…”

Section: Antihistamine Treatmentmentioning

confidence: 99%

Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges

Shirazian¹,

Aina²,

Park³

et al. 2017

IJNRD

111

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Chronic kidney disease-associated pruritus (CKD-aP) is a distressing, often overlooked condition in patients with CKD and end-stage renal disease. It affects ~40% of patients with end-stage renal disease and has been associated with poor quality of life, poor sleep, depression, and mortality. Prevalence estimates vary based on the instruments used to diagnose CKD-aP, and standardized diagnostic instruments are sorely needed. Treatment studies have often yielded conflicting results. This is likely related to studies that are limited by small sample size, flawed designs, and nonstandardized diagnostic instruments. Several large well-designed treatment trials have recently been completed and may soon influence CKD-aP management.

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Efficacy of topical cromolyn sodium 4% on pruritus in uremic nephrogenic patients: A randomized double-blind study in 60 patients

Cited by 42 publications

References 14 publications

Pulmonary hypertension among patients undergoing hemodialysis

Pulmonary hypertension among patients undergoing hemodialysis

Dermatologic manifestations in end stage renal disease

Chronic kidney disease-associated pruritus: impact on quality of life and current management challenges

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