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Identifying effective treatments for uremic pruritus
J K Tan1, H F Haberman, A J Coldman
1Division of Dermatology, University of British Columbia, Toronto, Ontario, Canada.
Journal of the American Academy of Dermatology
|November 1, 1991
Summary
Ultraviolet B phototherapy effectively treats uremic pruritus, a common condition in kidney disease patients. This treatment showed significant improvement in itching compared to other therapies.
Area of Science:
- Nephrology
- Dermatology
- Phototherapy
Background:
- Uremic pruritus is a common and distressing symptom in patients with chronic kidney disease.
- Effective treatments for uremic pruritus are limited, necessitating a review of existing evidence.
Purpose of the Study:
- To identify effective treatments for uremic pruritus through a systematic literature review.
- To evaluate the efficacy of various interventions based on randomized controlled trials.
Main Methods:
- A comprehensive literature search was conducted using MEDLINE and Index Medicus from 1966 to March 1991.
- Only randomized controlled clinical trials were included, with study quality assessed by two independent observers.
- A clinically significant therapeutic effect was defined as a 50% reduction in pruritus score and statistically significant improvement.
Main Results:
- Two of three whole-body ultraviolet B (UVB) trials demonstrated clinically significant outcomes.
- Meta-analysis of UVB trials confirmed a significant effect (pooled odds ratio 18; 95% CI 4, 161).
- Lidocaine, charcoal, and nicergoline trials showed improvement in either pruritus score or proportions, but not both.
Conclusions:
- Ultraviolet B phototherapy is the treatment of choice for moderate to severe uremic pruritus.
- UVB phototherapy offers a statistically significant and clinically meaningful benefit for patients suffering from uremic pruritus.
- Further research may explore other therapeutic avenues, but UVB remains the current gold standard.