Role of Gabapentin in the Treatment of Uremic Pruritus

Abstract

Available data support the use of gabapentin as a well-tolerated and effective treatment option for patients with UP who are unresponsive to traditional therapies. Further well-designed trials are warranted to establish the most appropriate dosing regimen in patients on HD.

Gabapentin for uremic pruritus: a systematic review of randomized controlled trials

“…A total of 17 journal articles were identified and assessed for eligibility. Nine were excluded because of the following reasons: one was a pilot study, two were reviews, two were retrospective studies, one was a protocol, one was a correspondence letter, and three were nonrandomized clinical trials (Fig. ).…”

“…The mechanism of action of gabapentin in the treatment of uremic pruritus is still unclear. Since it is structurally related to gamma‐aminobutyric acid, it may act on the voltage‐dependent calcium‐ion channels, inhibiting neuronal calcium influx and nerve impulses across synapses and interrupting the series of events that lead to uremic pruritus …”

Pregabalin versus gabapentin in the treatment of neuropathic pruritus in maintenance haemodialysis patients: A prospective, crossover study

“…Generally itch can be considered in two main types: pruritoceptive (peripheral, arising from skin) and neurogenic (neuropathic). Uraemic pruritus (UP) is a common symptom in patients requiring dialysis although the prevalence of UP has decreased by more than half with the advent of improved dialysis technology 17 . Renal transplantation is the only known cure for uraemic pruritus; however, this is not available for every ESRD patient.…”

Practice Gaps in Pruritus

“…Gabapentin has been found to be effective in uremic pruritus, [13][14][15] burns, 16 notalgia paresthestica, 17 neuropathic itch, 14 and itch occurring in palliative patients. 13,18 Additional agents that should be considered for the treatment of itch include pregabalin, mirtazapine, butorphenone, naltrexone, aprepitant, and narrow-band ultraviolet B.…”