[Does uremic pruritus in hemodialyzed patients disappear only with replacement therapy?]

Uremic itching is an "orphan" symptom, almost equally frustrating patients and physicians. It is an unpleasant sensation and a subjective experience which is difficult to qantitate. Studying the frequency of itching among the chosen group of chronic dialysis patients, there were two questions to be answered: 1) Does the itching correlate causatively to the standard laboratory parameters? and 2) Does the itching disappear with only supplementary treatment? At the commencement of the research a sequence of laboratory parameters, presence and intensity of itching were determined, and the presence of itching 3 months afterwards. Itching of the 3rd, 4th and 5th grade was present in 44 patients (37.9%) at the beginning. Patients with itching did not differ from those without itching regarding mean predialysis values of urea, creatinine, uric acid, hematocrit, calcium, phosphorus, alkaline phosphatase, i-PTH, ALT, bilirubin, Kt/V and total heparin doses received during single dialysis procedure. Among those with itching there were not significantly more patients older than 60 years of age (chi 2 = 0.273; p > 0.05). Three months afterwards itching disappeared without particular treatment in 8 of 44 patients (22.7%), and appeared in 14 of 72 (19.5%) patients without itching at the beginning of the investigation. In conclusion, no correlation was found between uremic itching and standard laboratory parameters. Itching in chronic dialysis patients is considered to be a temporary symptom that often disappears without supplementary treatment.