Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Uremic pruritus. Clinical and experimental studies.

M Ståhle-Bäckdahl1

  • 1Department of Dermatology, Karolinska Sjukhuset, Karolinska Institutet, Stockholm, Sweden.

Acta Dermato-Venereologica. Supplementum
|January 1, 1989
PubMed
Summary

Pruritus, or itching, affects many maintenance hemodialysis patients, worsening between treatments. This study suggests abnormal skin nerve patterns may cause uremic itching, not parathyroid hormone levels.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

The HCR gene on 6p21 is unlikely to be a psoriasis susceptibility gene.

The Journal of investigative dermatology·2001
Same author

Increased presence of eosinophilic granulocytes expressing transforming growth factor-beta1 in collagenous colitis.

Scandinavian journal of gastroenterology·2000
Same author

Characterization of five novel human genes in the 11q13-q22 region.

Biochemical and biophysical research communications·2000
Same author

The human cationic antimicrobial protein (hCAP-18) is expressed in the epithelium of human epididymis, is present in seminal plasma at high concentrations, and is attached to spermatozoa.

Infection and immunity·2000
Same author

Low-dose oral pulse methotrexate as monotherapy in elderly patients with bullous pemphigoid.

Journal of the American Academy of Dermatology·1999
Same author

The human cationic antimicrobial protein (hCAP18), a peptide antibiotic, is widely expressed in human squamous epithelia and colocalizes with interleukin-6.

Infection and immunity·1999

Area of Science:

  • Nephrology
  • Dermatology
  • Pathophysiology

Background:

  • Uremic pruritus is a common and distressing symptom in patients undergoing maintenance hemodialysis.
  • The exact mechanisms underlying uremic pruritus remain incompletely understood.
  • Factors such as parathyroid hormone (PTH) levels and skin hydration have been investigated as potential contributors.

Purpose of the Study:

  • To investigate the clinical characteristics of pruritus in maintenance hemodialysis patients.
  • To evaluate potential pathogenic factors contributing to uremic pruritus.
  • To explore the role of skin hydration, parathyroid hormone, and cutaneous innervation in uremic pruritus.

Main Methods:

  • Clinical data and routine laboratory tests were collected from hemodialysis patients.
  • Itch intensity was measured continuously over one week using a computerized method.
  • Skin hydration was assessed by measuring stratum corneum water content via electrical capacitance.
  • Serum parathyroid hormone (PTH) levels were measured.
  • Immunohistochemistry was used to examine skin biopsies for nerve fibers and PTH.
  • Intradermal injections of histamine and PTH fragments were administered to assess cutaneous responses.

Main Results:

  • 60-65% of patients experienced pruritus, with longer dialysis duration correlating with itching.
  • Itching intensity peaked nocturnally and was lowest after dialysis, suggesting pruritogen accumulation.
  • No significant difference in skin hydration was found between patients and controls, though a trend towards lower hydration in pruritic patients was observed.
  • Serum PTH levels were higher in pruritic patients, but no direct correlation with symptom severity or peripheral mediation was found.
  • Dialysis patients showed reduced flare reactions to histamine but increased itch responses, indicating heightened sensitivity.
  • Abnormal sprouting of neuron-specific enolase (NSE) immunoreactive nerve fibers was observed in the epidermis of hemodialysis patients, but not in controls.

Conclusions:

  • The accumulation of pruritogens between dialysis sessions likely contributes to uremic pruritus intensity.
  • Parathyroid hormone does not appear to be a direct peripheral mediator of uremic itching.
  • Patients with uremic pruritus exhibit augmented sensitivity to pruritogens.
  • Abnormal cutaneous innervation, characterized by epidermal nerve fiber sprouting, is a potential underlying factor in hemodialysis-associated pruritus.

Related Experiment Videos