Uraemic pruritus is not related to plasma histamine concentrations

Filippi, C.; Regazzini, R.; Piazza, V.; Galli, Francesco; Pisati, P.; Sacchi, Stefano; Salvadeo, A

doi:10.1111/j.1365-2230.1995.tb01328.x

Cited by 13 publications

(9 citation statements)

References 10 publications

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“…Some investigators have found a positive correlation between plasma histamine levels and pruritus [7, 8, 11, 15, 16], but this has not been confirmed by others [5, 30]. In our study, the plasma histamine levels of patients with pruritus were higher than those of nonpruritic patients, but the difference was not statistically significant (p = 0.06).…”

Section: Discussioncontrasting

confidence: 45%

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Histamine and Serotonin in Uremic Pruritus: Effect of Ondansetron in CAPD-Pruritic Patients

Balaskas¹,

Bamihas²,

Karamouzis³

et al. 1998

Nephron

105

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Pruritus is a common, unpleasant symptom of uremic patients. Serotonin and histamine have been reported as possible mediators of uremic pruritus, and ondansetron is a potent and selective inhibitor of 5-HT₃ receptors. The aims of our study were (1) to evaluate the effect of ondansetron on uremic pruritus in continuous ambulatory peritoneal dialysis (CAPD) patients and its safety and (2) to investigate the role of histamine and serotonin in uremic pruritus. To study the prevalence and pathogenesis of uremic pruritus, CAPD and hemodialysis (HD) patients were asked to complete a pruritus questionnaire. The replies were scored based on numerical scales, and the results were evaluated by the same investigator who did not know the patients. Pruritus was graded, according to the total points for each patient, as mild, moderate, or severe. Of 54 patients on HD, 29 (53.7%) had pruritus, and of 43 patients on CAPD, pruritus was present in 21 (48.8%). In HD patients, pruritus was mild in 14 (48.3%), moderate in 12 (41.4%), and severe in 3 (10.3%) patients; the distribution in CAPD patients was 9 (42.9%), 10 (47.6%), and 2 (9.5%), respectively. There was no correlation between the presence and severity of pruritus and age, sex, primary renal disease, duration of dialysis, dialysis solutions used, and hematological and biochemical parameters except for serum histamine and serotonin levels and their product. Plasma histamine levels in CAPD patients were 13.1 ± 1.1 ng/ml in pruritic and 11.0 ± 3.9 ng/ml in nonpruritic patients (p = 0.06), serum serotonin levels were 115.6 ± 43.3 ng/ml and 64 ± 42.3 ng/ml (p < 0.05), respectively, and the histamine × serotonin product was 1,461 ± 576 and 646 ± 545 (p < 0.01), respectively. Eleven CAPD patients (6 males, 5 females) with a mean age of 66 (range 33–83) years and an average time on CAPD of 18 (range 3–31) months with moderate to severe pruritus were treated with ondansetron (4 mg twice daily p.o.) for a mean period of 3 (range 1–5) months. All patients responded to the treatment. There was a significant reduction of the severity of pruritus from the start of treatment, and on the 3rd day the pruritic score (mean value) was 10 (range 5–19) points, while at time 0 (before treatment) it was 26 (range 19–37) points (p < 0.0001). Pruritus disappeared in 7 patients at the end of the 1st week and in all patients at the end of the 2nd week of treatment. This effect was maintained during the study. Plasma histamine levels decreased significantly during the treatment from 12.9 ± 1.2 to 6.7 ± 5.9 ng/ml (p < 0.05). Also, serum serotonin levels were reduced from 125.1 ± 47.8 to 59.3 ± 27.5 ng/ml (p < 0.05) at the end of the 1st month of treatment, and the histamine × serotonin product showed a more significant reduction: from 1,544 ± 656 to 454 ± 436 (p < 0.01). Three patients reported an improvement in their nausea and vomiting during the treatment. Weekly clinical and laboratory examinations showed no side effects, adverse reactions, or other complications. Our data indicate that o...

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Section: Discussioncontrasting

confidence: 45%

“…It was reported that plasma histamine levels were increased in uremic patients, mainly in those with pruritus [5, 7, 8, 11, 15, 16, 29, 30]. Some investigators have found a positive correlation between plasma histamine levels and pruritus [7, 8, 11, 15, 16], but this has not been confirmed by others [5, 30].…”

Section: Discussionmentioning

confidence: 79%

Histamine and Serotonin in Uremic Pruritus: Effect of Ondansetron in CAPD-Pruritic Patients

Balaskas¹,

Bamihas²,

Karamouzis³

et al. 1998

Nephron

105

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“…There is a correlation between plasma histamine levels and pruritus [52,55]. It is found that histamine levels in patients with UP is significant higher compared to nonpruritic subjects [52,55] but specific differences in plasma histamine levels in subjects with and without UP cannot be found [26,56]. Since antihistamine has been widely used but ineffective for the treatment of UP, histamine should not have a significant role for this symptom [57].…”

Section: Pathophysiologymentioning

confidence: 99%

Uremic Pruritus; Its Prevalence, Pathophysiology and Management

Aramwit¹,

Supasyndh²

2015

Updates in Hemodialysis

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“…Despite the evidence for release of histamine, there was no correlation found between plasma histamine levels and severity of pruritus and antihistamines lack any activity in uremic patients suggesting that plasma histamine does not play a remarkable role in uremic pruritus [ 14 ].…”

Section: Uremic Pruritusmentioning

confidence: 99%

Pruritus in Systemic Diseases: A Review of Etiological Factors and New Treatment Modalities

Tarikci

Kocatürk

Güngör

et al. 2015

The Scientific World Journal

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Pruritus is the most frequently described symptom in dermatology and can significantly impair the patient's quality of life. In 10–50% of adults with persistent pruritus, it can be an important dermatologic clue for the presence of a significant underlying systemic disease such as renal insufficiency, cholestasis, hematologic disorder, or malignancy (Etter and Myers, 2002; Zirwas and Seraly, 2001). This review describes the presence of pruritus in different systemic diseases. It is quite important to discover the cause of pruritus for providing relief for the patients experiencing substantial morbidity caused by this condition.

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Uraemic pruritus is not related to plasma histamine concentrations

Cited by 13 publications

References 10 publications

Histamine and Serotonin in Uremic Pruritus: Effect of Ondansetron in CAPD-Pruritic Patients

Histamine and Serotonin in Uremic Pruritus: Effect of Ondansetron in CAPD-Pruritic Patients

Uremic Pruritus; Its Prevalence, Pathophysiology and Management

Pruritus in Systemic Diseases: A Review of Etiological Factors and New Treatment Modalities

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