Uremic pruritus is improved by gabapentin

Yong, Adrian Sze Wai; Lee, Kevin Y. C.

doi:10.1111/ijd.12472

Cited by 8 publications

(4 citation statements)

References 3 publications

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“…Indeed, a previous study has shown a greater deposit of calcium in the deepest layer of the dermis of HD patients with more severe pruritus (25). Although calcium and phosphate were not found to be associated with pruritus in the present study, an elevated calcium × phosphate product has been associated with uremic pruritus (26), Considering the close relationship between calcium × phosphate product and hyperparathyroidism, this study cannot rule out the role of disturbances of serum calcium and phosphorus levels in the pathogenesis of pruritus among PD patients. In addition, we also observed that patients with a longer PD duration would experience severe pruritus, therefore more attention should be paid to the pruritus symptoms of those patient populations who have received longer PD treatment.…”

Section: Discussioncontrasting

confidence: 73%

Prevalence and Associated Factors of Uraemic Pruritus in Continuous Ambulatory Peritoneal Dialysis Patients

Guo

Lin

et al. 2015

Intern. Med.

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Objective Uraemic pruritus is a distressing symptom that has a negative impact on the quality of life for dialysis patients. The pathophysiology of pruritus in peritoneal dialysis (PD) patients is still poorly understood. The present study aims to investigate the prevalence and related risk factors of pruritus in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods In total, 362 CAPD cases were investigated from January 2012 to April 2013. Pruritus was assessed by visual analogue scale. Results The prevalence of severe pruritus and mild to moderate pruritus was 12.7% and 52.5%, respectively. The patients with severe pruritus had the longest duration of PD (p<0.001), Pittsburgh Sleep Quality Index (PSQI) score (p<0.001), Beck Depression Inventory (BDI) score (p=0.003), intact parathyroid hormone (iPTH) level (p=0.009), and the lowest Medical Outcomes Short Form 36 Health Survey, Physical Component Score (SF-36 PCS) (p<0.001) among the three groups. The patients with mild to moderate pruritus had a significantly higher iPTH level (p=0.004) compared with the patients without pruritus. A multivariate logistic regression for pruritus showed that higher PSQI score [odds ratio (OR)=1.305, p=0.001], higher BDI score (OR=1.429, p=0.002), longer vintage (OR=1.039, p=0.004), and higher iPTH level (OR=1.317, p= 0.014) were independently associated with pruritus. Conclusion The prevalence of uraemic pruritus was 65.2% in CAPD patients. Sleep disorder, depression, longer vintage, and a higher iPTH level were independent associated factors for pruritus in CAPD patients.

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Section: Discussioncontrasting

confidence: 73%

Prevalence and Associated Factors of Uraemic Pruritus in Continuous Ambulatory Peritoneal Dialysis Patients

Guo

Lin

et al. 2015

Intern. Med.

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“…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. ).…”

Section: Resultsmentioning

confidence: 99%

“…one was a pilot study, 4 two were reviews, 8,11 two were retrospective studies, 12,13 one was a protocol, 14 one was a correspondence letter, 15 and three were nonrandomized clinical trials [16][17][18] (Fig. 1).…”

Section: Study Selectionmentioning

confidence: 99%

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

2019

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Uremic pruritus is one of the most prevalent and bothersome dermatologic symptoms in patients with end‐stage renal disease. Some studies suggest a possible neuropathic cause of uremic pruritus. Gabapentin, an anticonvulsant, may control pruritus with neuropathic origin. The objectives of this study were to assess the efficacy of gabapentin in reducing pruritus scores of patients with uremic pruritus and evaluate its safety among dialysis patients. Meta‐analysis of randomized controlled trials, using gabapentin as treatment for uremic pruritus among hemodialysis patients was included and analyzed using Review Manager Version 5.1.4 software. Seven out of 17 screened articles were included, with a total of 315 participants. Meta‐analysis of the incidence of improved pruritus scores after treatment from four studies (n = 171) showed that treatment with gabapentin decreased the severity of uremic pruritus as compared to the placebo (risk ratio = 0.18; 95% confidence interval: 0.09, 0.33; I2 = 4%: P =< 0.00001). Six studies (n = 290) presented with incidence of adverse drug events such as dizziness, drowsiness, and somnolence. In the pooled analysis, treatment with gabapentin was associated with a higher incidence of adverse drug events compared to the comparator drugs, but the results were not significant (risk ratio = 1.3, 95% confidence interval: 0.81, 2.11; P = 0.28, I2 = 37%). The results of this systematic review suggest that gabapentin is efficacious and safe in improving uremic pruritus among dialysis patients.

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“…UP is often difficult to eradicate, although the symptoms can usually be mitigated. Current medications including gabapentin (a modulator of excitatory neurotransmitters) [10], capsaicin (a mediator of substance P release) [11], and cromolyn sodium (a mast cell stabilizer) [12, 13], have been suggested, but no specific, effective therapies are currently available for uremic pruritus [1, 3].…”

Section: Introductionmentioning

confidence: 99%

Chinese herbal bath therapy for the treatment of uremic pruritus: meta-analysis of randomized controlled trials

Xue

Zhao

Yuan

et al. 2019

BMC Complement Altern Med

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Background Chinese herbal bath therapy (CHBT) is a traditional external therapy that has been used for the treatment of uremic pruritus (UP) in China. We conducted a meta-analysis to evaluate the efficacy and safety of CHBT for UP. Methods We searched seven databases for studies published since database inception to September 1, 2018. Randomized trials evaluating CHBT for UP were collected. The therapeutic effects of CHBT were measured by the pruritus level (via the visual analogue scale (VAS) or the symptom score scale) and the total effective rate. We combined studies using mean difference (MD) for continuous outcomes and using risk ratio for dichotomous data, both with 95% confidence intervals. RevMan V.5.3 software was used to assess the data reported and perform the meta-analysis. Results Seventeen articles including 970 patients were identified. All participants were haemodialysis (HD) patients. CHBT is administered by immersing the whole body in a prepared herbal water bath. On average, an herbal bath prescription included 11 Chinese herbs. The mean treatment duration was 4.7 weeks. Compared with basic treatment (HD or haemoperfusion (HP)) and adding a control of sham CHBT, clear hot water bath, or calamine lotion, CHBT plus basic treatment reduced the VAS score (MD = − 2.38; 95% confidence intervals [CI], − 3.02 to − 1.74; P < 0.00001) and the symptom score (MD = − 8.42; 95% confidence intervals [CI], − 12.47 to − 4.36; P < 0.00001) and had a higher total effectiveness rate (risk ratio [RR] = 1.46; 95% CI, 1.31 to 1.63; P < 0.00001). Conclusions In conclusion, CHBT could be a complementary therapy for improving pruritic symptoms in uraemia patients. More rigorously designed, multicentre, prospective RCTs are warranted to further identify the efficacy and safety of CHBT. Trial registration Systematic review registration: [PROSPERO registration: CRD42018108506 ]. Electronic supplementary material The online version of this article (10.1186/s12906-019-2513-9) contains supplementary material, which is available to authorized users.

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Uremic pruritus is improved by gabapentin

Cited by 8 publications

References 3 publications

Prevalence and Associated Factors of Uraemic Pruritus in Continuous Ambulatory Peritoneal Dialysis Patients

Prevalence and Associated Factors of Uraemic Pruritus in Continuous Ambulatory Peritoneal Dialysis Patients

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

Chinese herbal bath therapy for the treatment of uremic pruritus: meta-analysis of randomized controlled trials

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