Pruritus and skin hydration during dialysis

Morton, C.A.; Lafferty, M.; Hau, C. M.; Henderson, I.A.; Jones, M. C.; Lowe, John

doi:10.1093/oxfordjournals.ndt.a027092

Cited by 161 publications

(145 citation statements)

References 12 publications

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“…Exacerbation of pruritus with dry skin was reported by 13 (65%) patients. Morton et al 8 revealed lower hydration of stratum corneum in uremic patients with pruritus and dry skin promotes sensation of itch by lowering the threshold for itch. In our study majority i.e, 15 (75%) of patients with pruritus reported exacerbation during sleep.…”

Section: Discussionmentioning

confidence: 99%

Dermatologic Manifestations In Chronic Kidney Disease Patients On Hemodialysis

Shrestha

Mathur

2016

Nepal J Dermatol Venereol & Leprol

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Introduction: Dermatologic changes are frequently seen in chronic kidney disease (CKD) patients. Early identification of these manifestations helps timely institution of treatment and prevention of progression of CKD.Objectives: The aim of this study was to evaluate the frequency and pattern of dermatologic problems among CKD patients who are on maintenance hemodialysis in our population. Material and Methods:A hospital based cross sectional comparative study was conducted. Fifty patients with CKD on hemodialysis were compared with the same number of non CKD patients. All the patients were clinically examined. Complementary diagnostic measures such as skin biopsy, gram stain, potassium hydroxide mounting and culture sensitivity of the lesions were carried out when necessary.Results: At least one dermatologic manifestation was present in 86% of the patients and changes were seen commonly in CKD patients who had GFR <15ml/min (83.8%). Cutaneous manifestations were significantly associated with CKD patients than control (p<0.001) but not with the duration of CKD and duration of hemodialysis. Thirty seven patients (74%) were having cutaneous lesions, commonest being xerosis (52%) followed by pruritus (40%) and hyperpigmentation (32%). Nail, mucous membrane and hair changes were present in 56%, 22% and 12% respectively, commonest being white nail (30%), furred tongue (18%), telogen effluvium (10%) respectively. Conclusion:In our study, dermatologic manifestations were common in CKD patients with GFR <15ml/min. Cutaneous and nail changes were seen in 74% and 56% of the CKD patients undergoing hemodialysis, commonest changes being xerosis and white nail respectively.

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Section: Discussionmentioning

confidence: 99%

Dermatologic Manifestations In Chronic Kidney Disease Patients On Hemodialysis

Shrestha

Mathur

2016

Nepal J Dermatol Venereol & Leprol

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“…72 Several additional non-controlled trials have also shown the beneficial effects of compounds containing emollient creams in patients with xerosis and CKD-aP. 71,[73][74][75][76] In a prospective clinical trial, 200 g of a aqueous cream applied twice daily significantly improved pruritus severity in 16 out of 21 recruited dialysis patients and resulted in the abatement of itching in 9 patients. 75 In a prospective study of 21 HD patients, all treated with structured physiological lipids and endogenous cannabinoids twice daily for 3 weeks, pruritus severity was significantly reduced at the end of the treatment period and pruritus completely abated in 8 of 21 participants.…”

Section: Xerosis Treatmentmentioning

confidence: 99%

“…71,[73][74][75][76] In a prospective clinical trial, 200 g of a aqueous cream applied twice daily significantly improved pruritus severity in 16 out of 21 recruited dialysis patients and resulted in the abatement of itching in 9 patients. 75 In a prospective study of 21 HD patients, all treated with structured physiological lipids and endogenous cannabinoids twice daily for 3 weeks, pruritus severity was significantly reduced at the end of the treatment period and pruritus completely abated in 8 of 21 participants. 76 However, despite the proven effectiveness of emollient creams in treating xerosis, no trials have tested its effect on pruritus in a double-blind, placebo-controlled fashion.…”

Section: Xerosis 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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“…It was seen that xerosis was more common in diabetics and in our study diabetes was the most common reason of CKD. One study revealed lower levels of stratum corneum hydration as the cause of xerosis but another study implicated reduction in the size of eccrine glands as the cause 7,11 . Hyperpigmentation was seen in 30 (25%) patientswhich was similar to various other studies 11 .…”

Section: Discussionmentioning

confidence: 99%

“…One study revealed lower levels of stratum corneum hydration as the cause of xerosis but another study implicated reduction in the size of eccrine glands as the cause 7,11 . Hyperpigmentation was seen in 30 (25%) patientswhich was similar to various other studies 11 . Failure of the kidneys to secrete beta-melano-stimulating hormone resulting in increased deposition of melanin in the skin has been implicated for this 12 .…”

Section: Discussionmentioning

confidence: 99%