Oral Activated Charcoal in Patients with Uremic Pruritus

Abstract

Twenty-three chronic uremic patients on maintenance hemodialysis and suffering from severe pruritus were treated with activated powdered charcoal (6 g daily p.o.)· In 10 patients pruritus disappeared completely, and in 10 other patients a partial effect was observed. The favorable results persisted for several weeks after discontinuation of the treatment. Only 3 cases were totally unresponsive. No relevant undesirable side effects were observed with the exception of 1 case who showed treatment intolerance. It is concluded that activated charcoal per os is a safe, effective, and low-cost therapy for patients with uremic pruritus, but its mechanism of action is unknown.

Dermatologic manifestations in end stage renal disease

“…The exact mechanism of action of activated charcoal is unknown but it has been suggested to act by binding pruritogens in the intestinal lumen thus preventing their absorption and action . Activated charcoal has shown efficacy in two small trials . Additionally, this treatment option is cost effective with limited side effects.…”

“…31 Activated charcoal has shown efficacy in two small trials. 32,33 Additionally, this treatment option is cost effective with limited side effects. Lastly, the role of phototherapy in uremic pruritus treatment has also been examined.…”

Uremic Pruritus – An Update

“…The favorable results persisted for several weeks after discontinuation of treatment. Activated charcoal orally may be a safe and effective treatment for uremic pruritus [88]. Heparin, a multiple detoxificating agent [89], was used in the small unblinded study.…”

Dialyseassoziierte Hautver�nderungen

“…Antihistaminika und Mastzellstabilisatoren sind meist wirkungslos,wohingegen die Gabe von Aktivkohle oft Erfolg hat, allerdings ist eine Dosis von 6 g täglich notwendig. Ein möglicher Wirkmechanismus scheint hier die enterale Absorption und Elimination pruritogener Substanzen zu sein [5].Kurzfristig erfolgreich können Morphinantagonisten wie z. B. Naltrexon sein, während Serotoninantagonisten wie Ondansetron meist unwirksam sind.Unter der Gabe von Erythropoetin konnte gezeigt werden,dass die Histaminspiegel im Blut gesenkt werden können,allerdings ist die Wirksamkeit auf den Juckreiz eher gering.…”