Treatment of the uremic patient’s pruritus with emolients and gabapentine and life quality impact
Keywords:
end stage renal disease peritoneal dialysis, hemodialysis, pruritus, gabapentin, emollientsAbstract
Introduction: The symptom that patients most often present with end stage renal disease (ESRD) in renal replacement therapy (RRT) like hemodialysis and peritoneal dialysis is uremic pruritus.
Objective: To compare the effectiveness of emollients vs gabapentin in the management of uremic pruritus and the impact on the quality of life in patients with ESRD in RRT type hemodialysis and peritoneal dialysis at the Hospital Pablo Tobón Uribe’s Renal therapy service between January and April of 2010.
Methodology: We conducted a clinical trial, controlled randomized, unblinded. We administered emollients or gabapentin as a treatment in groups of patients with chronic renal failure and itching who came to the Hospital Pablo Tobón Uribe's Renal therapy service to receive renal replacement therapy like hemodialysis or peritoneal dialysis.
Results: Both groups noted substantial improvement of the pruritus. 15 Patients treated with gabapentin , found a decrease of intense itching, measured by the visual analogue scale, from an average of 6.6 at the start to 1.1 at the end. The same case happened with the 18 patients in the group that received emollients, from an average of 5.2 at the start to 1.3 at the end. With regard to the evaluation of the quality of life, differences were observed only for the domain of social functionality in the group of emollients, between the first and second evaluation without seen significant differences in the Group of gabapentin.
Conclusions: With the both treatment, the patients experienced a statistically significant improvement in the itching, however, when compared the two treatments, there was no significant difference in the improvement. So, we cannot be asserting, with the obtained sample size that a treatment is better than another. As regards the quality of life, only the Group of emollients appreciated improvement in the domain of social functionality.
Author Biographies
Laura Elena Parra
Médica, residente en Dolor y Cuidado Paliativo, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia
Flavio Alberto Restrepo
Médico, residente en Dermatología, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia
Luz Marina Gómez
Médica dermatóloga; jefe, Servicio de Dermatología, Universidad Pontificia Bolivariana, Medellín, Colombia
John Jairo Vargas
Médico, especialista en Dolor y Cuidado Paliativo; jefe, Servicio de Dolor y Cuidado Paliativo, Universidad Pontificia Bolivariana, Medellín, Colombia
References
1. Traue DC, Ross JR. Palliative care in non-malignant diseases. J R Soc Med. 2005;98:503-6.
2. US Renal Data Systems. USRDS 2009 Annual Data Report: Atlas of chronic kidney disease & end-stage renal disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2009.
3. Akhyani M, Ganji MR, Samadi N, Khamesan B, Daneshpazhooh M. Pruritus in hemodialysis patients. BMC Dermatol. 2005;24:5-7.
4. Stahle-Backdahl M. Uremic pruritus. Semin Dermatol.1995;14:25-9.
5. Mistik S, Utas S, Ferahbas A, Tokgoz B, Unsal G, Sahan H, et al. An epidemiology study of patients with uremic pruritus. J Eur Acad Dermatol Venereol. 2006;20:672-8.
6. Aucella F, Gesuete A. Uremic pruritus: An unresolved challenge. G Ital Nefrol. 2009;26:585-99.
7. Weisshaar E, Dunker N, Gollnick H. Topical capsaicin therapy in humans with hemodialysis-related pruritus. Neurosci Lett. 2003;345:192-4.
8. Makhlough A. Topical capsaicin therapy for uremic pruritus in patients on hemodialysis. Iran J Kidney Dis. 2010;4:137-40.
9. Lysy J, Sistiery-Ittah M, Israelit Y, Shmueli A, StraussLiviatan N, Mindrul V, et al. Topical capsaicin –a novel and effective treatment for idiopathic intractable pruritus ani: A randomized, placebo controlled, crossover study. Gut. 2003;52:1323-6.
10. Pauli-Magnus C, Klumpp S, Alscher DM, Kuhlmann U, Mettang T. Short-term efficacy of tacrolimus ointment in severe uremic pruritus. Perit Dial Int. 2000;20:802-3.
11. Kuypers DR, Claes K, Evenepoel P, Maes B, Vanrenterghem Y. A prospective proof of concept study of the efficacy of tacrolimus ointment on uraemic pruritus in patients on chronic dialysis therapy. Nephrol Dial Transplant. 2004;19:1895-901.
12. Duque MI, Yosipovitch G, Fleischer AB Jr, Willard J, Freedman BI. Lack of efficacy of tacrolimus ointment 0.1% for treatment of hemodialysis-related pruritus: A randomized, double-blind, vehicle-controlled study. J Am Acad Dermatol. 2005;52:519-21.
13. Ivard JR, Henry W. Ultraviolet phototherapy for pruritus. Dermatol Ther. 2005;18:344-54.
14. Hsu MM, Yang CC. Uraemic pruritus responsive to broadband ultraviolet (UV) B therapy does not readily respond to narrowband UVB therapy. Br J Dermatol. 2003;149:888-9.
15. Berneburg M, Cken M, Benedix F. Phototherapy with narrowband Vs. broadband UVB. Acta Derm Venereol. 2005;85:98-108.
16. Pugashetti R, Lim HW, Koo J. Broadband UVB revisited: Is the narrowband UVB fad limiting our therapeutic options? J Dermatolog Treat. 2009; 21:326-30.
17. Manenti L, Vaglio A. Gabapentin for uraemic pruritos. Nephrol Dial Transplant. 2005;20:1278-9.
18. Gunal A, Ozalp G, Yoldas TK, Gunal SY, Kirciman E, Celiker H. Gabapentin therapy for pruritus in haemodialysis patients: A randomized, placebo-controlled, double-blind trial. Nephrol Dial Transplant. 2004;19:3137-9.
19. O’Donoghue M, Harp MDT. Antihistamines and their role as antipruritics. Dermatol Ther. 2005;18:333-40.
20. Francos GC, Kauh YC, Gittlen SD, Schulman ES, Besarab A, Goyal S, et al. Elevated plasma histamine in chronic uremia. Effects of ketotifen on pruritus. Int J Dermatol. 1991;30:884-9.
21. Rosner MH. Cromolyn sodium: A potential therapy for uremic pruritus? Hemodial Int. 2006;10:189-92.
22. Pauli-Magnus C, Mikus G, Alscher DM. Naltrexone does not relieve uremic pruritus: Results of a randomized, doubleblind, placebo-controlled crossover study. J Am Soc Nephrol. 2000;11:514-9.
23. Balaskas EV, Bamihas GI, Karamouzis M, Voyiatzis G, Tourkantonis A. Histamine and serotonin in uremic pruritus: Effect of ondansetron in CAPD-pruritic patients. Nephron. 1998;78:395-402.
24. Wikström B, Gellert R, Ladefoged SD, Danda Y, Akai M, Ide K, et al. Kappa-opioid system in uremic pruritus: Multicenter, randomized, double-blind, placebo-controlled clinical studies. J Am Soc Nephrol. 2005;16:3742-7.
25. Ashmore SD, Jones CH, Newstead CG, Daly MJ, Chrystyn H. Ondansetron therapy for uremic pruritus in hemodialysis patients. Am J Kidney Dis. 2000;35:827-31.2
26. Greaves MW. Itch in systemic disease: Therapeutic options. Dermatol Ther. 2005;18:323-7.
27. Hiroshige K, Kabashima N, Takasugi M, Kuroiwa A. Optimal dialysis improves uremic pruritus. Am J Kidney Dis. 1995;25:413-9.
28. Razeghi E, Eskandari D, Ganji MR, Meysamie AP, Togha M, Khashayar P. Gabapentin and uremic pruritus in hemodialysis patients. Ren Fail. 2009;31:85-90.
29. Vila T, Gommer J, Scates AC. Role of gabapentin in the treatment of uremic pruritus. Ann Pharmacother. 2008;42:1080-4.
30. Boaz M, Shtendik L, Oron M, Portugal-Cohen M, Kohen R, Biro A, et al. A randomized controlled clinical trial comparing the efficacy of dead sea mineral-enriched body lotion versus two types of placebo in the treatment of cutaneous dryness, itching, peeling and tightness in hemodialysis patients (EDIT). Nephron Clin Pract. 2009;113:169-76.
31. Lugo LH, García HI, Gómez C. Confiabilidad del cuestionario de calidad de vida en salud SF-36 en Medellín, Colombia. Rev Fac Nac Salud Pública. 2006;24:37-50
32. Kuypers DR. Skin problems in chronic kidney disease. Nat Clin Pract Nephrol. 2009;5:157-70.
33. Kosmadakis GCh, Papakonstantinou S, Theodoros C, Emmanouel P, Demetrios V, Nicolas Z. Characteristics of uremic pruritus in hemodialysis patients: Data from a single center. Kidney Int. 2008;74:962-3.
34. Narita I, Iguchi S, Omori K, Gejyo F. Uremic pruritus in chronic hemodialysis patients. J Nephrol. 2008;21:161-5.
35. Novak MJ, Sheth H, Bender FH, Fried L, Piraino B. Improvement in Pittsburgh Symptom Score index after initiation of peritoneal dialysis. Adv Perit Dial. 2008;24:46-50.
36. Gómez RA. Renal disease in Colombia. Ren Fail. 2006;28:643-7.
37. Gómez R, editor. Datos colombianos de diálisis y trasplantes para el Registro Latinoamericano de Diálisis [internet]. Bogotá: Asociación Colombiana de Nefrología de Hipertensión Arterial; 2005.: Disponible en: http://www.slanh.org.
38. Sanabria M, Muñoz J, Trillos C, Hernández G, Latorre C, Díaz CS, et al. Dialysis outcomes in Colombia (DOC) study: A comparison of patient survival on peritoneal dialysis Vs. hemodialysis in Colombia. Kidney Int. 2008;108(Suppl.):S165-72.
39. Twycross R, Greaves MW, Handwerker H, Jones EA, Libretto SE, Szepietowski JC, et al. Itch: scratching more than the surface. QJM. 2003;96:7.
40. Yosipovitch G, Greaves MW, Schmelz M. Itch. Lancet. 2003;361:690.
41. Gilchrest BA, Stern RS, Steinman TI, Brown RS, Arndt KA, Anderson WW. Clinical features of pruritus among patients undergoing maintenance hemodialysis. Arch Dermatol. 1982;118:154.
42. Aucella F, Vigilante M, Gesuete A, Maruccio G, Specchio A, Gesualdo L. Uraemic itching: Do polymethylmethacrylate dialysis membranes play a role? Nephrol Dial Transplant. 2007;22:S8-12.
43. Wikstrom B. Itchy skin, a clinical problem for haemodialysis patients. Nephrol Dial Transplant. 2007;22:S37-8.
44. Gonella M, Calibrese G, Mazzotta A, Vagelli G. Uraemic pruritus in RDT patients: Is it still a problem? Nephrol Dial Transplant. 2006;21:3495-505.
45. Murphy M, Carmichael AJ. Renal itch. Clin Exp Dermatol. 2000;25:103-6.
46. Ponticelli C, Becini PL. Uremic pruritus: A review. Nephron.1992;60:1-5.
47. Chen YC, Chiu WT, Wu MS. Therapeutic effect of topical gamma-linolenic acid on refractory uremic pruritus. Am J Kidney Dis. 2006;48:69-76.
48. Szepietowski JC, Szepietowski T, Reich A. Efficacy and tolerance of the cream containing structured physiological lipids with endocannabinoids in the treatment of uremic pruritus: A preliminary study. Acta Dermatovenerol Croat. 2005;13:97-103.
49. Mettang M, Weisshaar E. Pruritus: Control of itch in patients undergoing dialysis. Skin Therapy Lett. 2010;5:1-5.
50. Pereira U, Boulais N, Lebonvallet N, Pennec JP, Dorange G, Misery L. Mechanisms of sensory effects of tacrolimus on the skin. Br J Dermatol. 2010; 163:70-7.
51. Manenti L, Vaglio A, Borgatti PP. Gabapentin as a therapeutic option in uremic pruritus. Kidney Int. 2008;73:512-3.
52. Manenti L, Vaglio A. Gabapentin use in chronic uraemic itch is in line with emerging pathogenetic hypothesis. Nephrol Dial Transplant. 2007;22:3669-70.
53. Morton CA, Lafferty M, Hau C, Henderson I, Jones M, Lowe JG. Pruritus and skin hydration during dialysis. Nephrol Dial Transplant. 1996;11:2031-6.
54. Ostlere LS, Taylor C, Baillod R, Wright S. Relationship between pruritus, transepidermal water loss, and biochemical markers of renal itch in haemodialysis patients. Nephrol Dial Transplant. 1994;9:1302-4.
55. Razeghi E, Eskandari D, Ganji MR, Meysamie AP, Togha M, Khashayar P. Gabapentin and uremic pruritus in hemodialysis patients. Ren Fail. 2009;31:85-90.
56. Durrant-Finn U, Osten B, Mügge C, Nenoff P. Pruritus and dryness of the skin in chronic kidney insufficiency and dialysis patients - a review. Wien Med Wochenschr. 2009;159:317-26.
57. Dyachenko P, Shustak A, Rozenman D. Hemodialysis-related pruritus and associated cutaneous manifestations. Int J Dermatol. 2006;45:664-7.
58. Tercedor J, López-Hernández B, Rodenas JM, Herranz MT, Serrano-Ortega S. Erythropoietin therapy for uremic pruritus. N Engl J Med. 1992;327:734.
59. Balaskas EV, Uldall RP. Erythropoietin treatment does not improve uremic pruritus. Perit Dial Int. 1992;12:330-1.
60. Phan NQ, Bernhard JD, Luger TA, Ständer S. Antipruritic treatment with systemic mu-opioid receptor antagonists: A review. J Am Acad Dermatol. 2010; 63: 680-8
61. Nasrollahi AR, Miladipour A, Ghanei E, Yavari P, Haghverdi F. Montelukast for treatment of refractory pruritus in patients on hemodialysis. Iran J Kidney Dis. 2007;1:73-7.
62. Yosipovitch G, Fleischer A. Itch associated with skin disease: Advances in pathophysiology and emerging therapies. Am J Clin Dermatol. 2003;4:617-22.
63. Greaves MW. Pathogenesis and treatment of pruritus. Curr Allergy Asthma Rep. 2010;10 :236-42.
64. Seckin D, Demircay Z, Akin O. Generalized pruritus treated with narrowband UVB. Int J Dermatol. 2007;46:367-70.
2. US Renal Data Systems. USRDS 2009 Annual Data Report: Atlas of chronic kidney disease & end-stage renal disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2009.
3. Akhyani M, Ganji MR, Samadi N, Khamesan B, Daneshpazhooh M. Pruritus in hemodialysis patients. BMC Dermatol. 2005;24:5-7.
4. Stahle-Backdahl M. Uremic pruritus. Semin Dermatol.1995;14:25-9.
5. Mistik S, Utas S, Ferahbas A, Tokgoz B, Unsal G, Sahan H, et al. An epidemiology study of patients with uremic pruritus. J Eur Acad Dermatol Venereol. 2006;20:672-8.
6. Aucella F, Gesuete A. Uremic pruritus: An unresolved challenge. G Ital Nefrol. 2009;26:585-99.
7. Weisshaar E, Dunker N, Gollnick H. Topical capsaicin therapy in humans with hemodialysis-related pruritus. Neurosci Lett. 2003;345:192-4.
8. Makhlough A. Topical capsaicin therapy for uremic pruritus in patients on hemodialysis. Iran J Kidney Dis. 2010;4:137-40.
9. Lysy J, Sistiery-Ittah M, Israelit Y, Shmueli A, StraussLiviatan N, Mindrul V, et al. Topical capsaicin –a novel and effective treatment for idiopathic intractable pruritus ani: A randomized, placebo controlled, crossover study. Gut. 2003;52:1323-6.
10. Pauli-Magnus C, Klumpp S, Alscher DM, Kuhlmann U, Mettang T. Short-term efficacy of tacrolimus ointment in severe uremic pruritus. Perit Dial Int. 2000;20:802-3.
11. Kuypers DR, Claes K, Evenepoel P, Maes B, Vanrenterghem Y. A prospective proof of concept study of the efficacy of tacrolimus ointment on uraemic pruritus in patients on chronic dialysis therapy. Nephrol Dial Transplant. 2004;19:1895-901.
12. Duque MI, Yosipovitch G, Fleischer AB Jr, Willard J, Freedman BI. Lack of efficacy of tacrolimus ointment 0.1% for treatment of hemodialysis-related pruritus: A randomized, double-blind, vehicle-controlled study. J Am Acad Dermatol. 2005;52:519-21.
13. Ivard JR, Henry W. Ultraviolet phototherapy for pruritus. Dermatol Ther. 2005;18:344-54.
14. Hsu MM, Yang CC. Uraemic pruritus responsive to broadband ultraviolet (UV) B therapy does not readily respond to narrowband UVB therapy. Br J Dermatol. 2003;149:888-9.
15. Berneburg M, Cken M, Benedix F. Phototherapy with narrowband Vs. broadband UVB. Acta Derm Venereol. 2005;85:98-108.
16. Pugashetti R, Lim HW, Koo J. Broadband UVB revisited: Is the narrowband UVB fad limiting our therapeutic options? J Dermatolog Treat. 2009; 21:326-30.
17. Manenti L, Vaglio A. Gabapentin for uraemic pruritos. Nephrol Dial Transplant. 2005;20:1278-9.
18. Gunal A, Ozalp G, Yoldas TK, Gunal SY, Kirciman E, Celiker H. Gabapentin therapy for pruritus in haemodialysis patients: A randomized, placebo-controlled, double-blind trial. Nephrol Dial Transplant. 2004;19:3137-9.
19. O’Donoghue M, Harp MDT. Antihistamines and their role as antipruritics. Dermatol Ther. 2005;18:333-40.
20. Francos GC, Kauh YC, Gittlen SD, Schulman ES, Besarab A, Goyal S, et al. Elevated plasma histamine in chronic uremia. Effects of ketotifen on pruritus. Int J Dermatol. 1991;30:884-9.
21. Rosner MH. Cromolyn sodium: A potential therapy for uremic pruritus? Hemodial Int. 2006;10:189-92.
22. Pauli-Magnus C, Mikus G, Alscher DM. Naltrexone does not relieve uremic pruritus: Results of a randomized, doubleblind, placebo-controlled crossover study. J Am Soc Nephrol. 2000;11:514-9.
23. Balaskas EV, Bamihas GI, Karamouzis M, Voyiatzis G, Tourkantonis A. Histamine and serotonin in uremic pruritus: Effect of ondansetron in CAPD-pruritic patients. Nephron. 1998;78:395-402.
24. Wikström B, Gellert R, Ladefoged SD, Danda Y, Akai M, Ide K, et al. Kappa-opioid system in uremic pruritus: Multicenter, randomized, double-blind, placebo-controlled clinical studies. J Am Soc Nephrol. 2005;16:3742-7.
25. Ashmore SD, Jones CH, Newstead CG, Daly MJ, Chrystyn H. Ondansetron therapy for uremic pruritus in hemodialysis patients. Am J Kidney Dis. 2000;35:827-31.2
26. Greaves MW. Itch in systemic disease: Therapeutic options. Dermatol Ther. 2005;18:323-7.
27. Hiroshige K, Kabashima N, Takasugi M, Kuroiwa A. Optimal dialysis improves uremic pruritus. Am J Kidney Dis. 1995;25:413-9.
28. Razeghi E, Eskandari D, Ganji MR, Meysamie AP, Togha M, Khashayar P. Gabapentin and uremic pruritus in hemodialysis patients. Ren Fail. 2009;31:85-90.
29. Vila T, Gommer J, Scates AC. Role of gabapentin in the treatment of uremic pruritus. Ann Pharmacother. 2008;42:1080-4.
30. Boaz M, Shtendik L, Oron M, Portugal-Cohen M, Kohen R, Biro A, et al. A randomized controlled clinical trial comparing the efficacy of dead sea mineral-enriched body lotion versus two types of placebo in the treatment of cutaneous dryness, itching, peeling and tightness in hemodialysis patients (EDIT). Nephron Clin Pract. 2009;113:169-76.
31. Lugo LH, García HI, Gómez C. Confiabilidad del cuestionario de calidad de vida en salud SF-36 en Medellín, Colombia. Rev Fac Nac Salud Pública. 2006;24:37-50
32. Kuypers DR. Skin problems in chronic kidney disease. Nat Clin Pract Nephrol. 2009;5:157-70.
33. Kosmadakis GCh, Papakonstantinou S, Theodoros C, Emmanouel P, Demetrios V, Nicolas Z. Characteristics of uremic pruritus in hemodialysis patients: Data from a single center. Kidney Int. 2008;74:962-3.
34. Narita I, Iguchi S, Omori K, Gejyo F. Uremic pruritus in chronic hemodialysis patients. J Nephrol. 2008;21:161-5.
35. Novak MJ, Sheth H, Bender FH, Fried L, Piraino B. Improvement in Pittsburgh Symptom Score index after initiation of peritoneal dialysis. Adv Perit Dial. 2008;24:46-50.
36. Gómez RA. Renal disease in Colombia. Ren Fail. 2006;28:643-7.
37. Gómez R, editor. Datos colombianos de diálisis y trasplantes para el Registro Latinoamericano de Diálisis [internet]. Bogotá: Asociación Colombiana de Nefrología de Hipertensión Arterial; 2005.: Disponible en: http://www.slanh.org.
38. Sanabria M, Muñoz J, Trillos C, Hernández G, Latorre C, Díaz CS, et al. Dialysis outcomes in Colombia (DOC) study: A comparison of patient survival on peritoneal dialysis Vs. hemodialysis in Colombia. Kidney Int. 2008;108(Suppl.):S165-72.
39. Twycross R, Greaves MW, Handwerker H, Jones EA, Libretto SE, Szepietowski JC, et al. Itch: scratching more than the surface. QJM. 2003;96:7.
40. Yosipovitch G, Greaves MW, Schmelz M. Itch. Lancet. 2003;361:690.
41. Gilchrest BA, Stern RS, Steinman TI, Brown RS, Arndt KA, Anderson WW. Clinical features of pruritus among patients undergoing maintenance hemodialysis. Arch Dermatol. 1982;118:154.
42. Aucella F, Vigilante M, Gesuete A, Maruccio G, Specchio A, Gesualdo L. Uraemic itching: Do polymethylmethacrylate dialysis membranes play a role? Nephrol Dial Transplant. 2007;22:S8-12.
43. Wikstrom B. Itchy skin, a clinical problem for haemodialysis patients. Nephrol Dial Transplant. 2007;22:S37-8.
44. Gonella M, Calibrese G, Mazzotta A, Vagelli G. Uraemic pruritus in RDT patients: Is it still a problem? Nephrol Dial Transplant. 2006;21:3495-505.
45. Murphy M, Carmichael AJ. Renal itch. Clin Exp Dermatol. 2000;25:103-6.
46. Ponticelli C, Becini PL. Uremic pruritus: A review. Nephron.1992;60:1-5.
47. Chen YC, Chiu WT, Wu MS. Therapeutic effect of topical gamma-linolenic acid on refractory uremic pruritus. Am J Kidney Dis. 2006;48:69-76.
48. Szepietowski JC, Szepietowski T, Reich A. Efficacy and tolerance of the cream containing structured physiological lipids with endocannabinoids in the treatment of uremic pruritus: A preliminary study. Acta Dermatovenerol Croat. 2005;13:97-103.
49. Mettang M, Weisshaar E. Pruritus: Control of itch in patients undergoing dialysis. Skin Therapy Lett. 2010;5:1-5.
50. Pereira U, Boulais N, Lebonvallet N, Pennec JP, Dorange G, Misery L. Mechanisms of sensory effects of tacrolimus on the skin. Br J Dermatol. 2010; 163:70-7.
51. Manenti L, Vaglio A, Borgatti PP. Gabapentin as a therapeutic option in uremic pruritus. Kidney Int. 2008;73:512-3.
52. Manenti L, Vaglio A. Gabapentin use in chronic uraemic itch is in line with emerging pathogenetic hypothesis. Nephrol Dial Transplant. 2007;22:3669-70.
53. Morton CA, Lafferty M, Hau C, Henderson I, Jones M, Lowe JG. Pruritus and skin hydration during dialysis. Nephrol Dial Transplant. 1996;11:2031-6.
54. Ostlere LS, Taylor C, Baillod R, Wright S. Relationship between pruritus, transepidermal water loss, and biochemical markers of renal itch in haemodialysis patients. Nephrol Dial Transplant. 1994;9:1302-4.
55. Razeghi E, Eskandari D, Ganji MR, Meysamie AP, Togha M, Khashayar P. Gabapentin and uremic pruritus in hemodialysis patients. Ren Fail. 2009;31:85-90.
56. Durrant-Finn U, Osten B, Mügge C, Nenoff P. Pruritus and dryness of the skin in chronic kidney insufficiency and dialysis patients - a review. Wien Med Wochenschr. 2009;159:317-26.
57. Dyachenko P, Shustak A, Rozenman D. Hemodialysis-related pruritus and associated cutaneous manifestations. Int J Dermatol. 2006;45:664-7.
58. Tercedor J, López-Hernández B, Rodenas JM, Herranz MT, Serrano-Ortega S. Erythropoietin therapy for uremic pruritus. N Engl J Med. 1992;327:734.
59. Balaskas EV, Uldall RP. Erythropoietin treatment does not improve uremic pruritus. Perit Dial Int. 1992;12:330-1.
60. Phan NQ, Bernhard JD, Luger TA, Ständer S. Antipruritic treatment with systemic mu-opioid receptor antagonists: A review. J Am Acad Dermatol. 2010; 63: 680-8
61. Nasrollahi AR, Miladipour A, Ghanei E, Yavari P, Haghverdi F. Montelukast for treatment of refractory pruritus in patients on hemodialysis. Iran J Kidney Dis. 2007;1:73-7.
62. Yosipovitch G, Fleischer A. Itch associated with skin disease: Advances in pathophysiology and emerging therapies. Am J Clin Dermatol. 2003;4:617-22.
63. Greaves MW. Pathogenesis and treatment of pruritus. Curr Allergy Asthma Rep. 2010;10 :236-42.
64. Seckin D, Demircay Z, Akin O. Generalized pruritus treated with narrowband UVB. Int J Dermatol. 2007;46:367-70.
How to Cite
1.
Parra LE, Restrepo FA, Gómez LM, Vargas JJ. Treatment of the uremic patient’s pruritus with emolients and gabapentine and life quality impact. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 2019 Feb. 27 [cited 2024 Jul. 3];18(4):196-204. Available from: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/335
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How to Cite
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Parra LE, Restrepo FA, Gómez LM, Vargas JJ. Treatment of the uremic patient’s pruritus with emolients and gabapentine and life quality impact. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 2019 Feb. 27 [cited 2024 Jul. 3];18(4):196-204. Available from: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/335
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