Uremic pruritus

Renal itch is a localized or generalized itch, affecting patients with Chronic Renal Failure, where there is no primary skin disease and no systemic or psychological dysfunction that might cause pruritus. Uremic pruritus (UP) is an unpleasant sensation, rarely appearing in earlier stages of chronic kidney disease. Renal transplantation is the definite solution for that problem. The prevalence of UP has been reduced during the last years, possibly, due to a more efficient dialysis, with more biocompatible filters. During the last decades a big number of substances were considered to be etiologic factors of UP, and an even bigger number of therapeutic substances appeared with promising potentials and conflicting results in the course of their use. The main reason for this disorientation is the lack of sound evidence on the pathogenetic mechanisms that may potentiate UP. 'Inflammatory' and 'opioid' hypothesis are the best studied and the reduction of UP is a fact. Nevertheless the mechanisms of the pathogenesis of UP are still under investigation and a long way has to be done in order to achieve more definite results.