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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
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Pruritus in chronic kidney disease.

Nupur N Uppal1, Antonio Corona, Steven Fishbane

  • 1Division of Nephrology, Department of Medicine, Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, USA.

Current Opinion in Nephrology and Hypertension
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Summary

Kidney disease patients frequently suffer from pruritus, impacting their quality of life. New research and treatments, including the first approved medication, offer improved management for this common symptom.

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Area of Science:

  • Nephrology
  • Dermatology
  • Clinical Medicine

Background:

  • Pruritus is a frequent and distressing symptom in patients with kidney disease.
  • It significantly impacts patients' quality of life, often underestimated by healthcare providers.
  • The underlying mechanisms of pruritus are being increasingly elucidated.

Purpose of the Study:

  • To review the current understanding of pruritus in kidney disease.
  • To highlight recent advancements in research and treatment options.
  • To emphasize the growing focus on symptom management in nephrology.

Main Methods:

  • Comprehensive literature review of recent studies on kidney disease-related pruritus.
  • Analysis of emerging research on pathogenesis and treatment modalities.
  • Evaluation of clinical trial data for novel therapies.

Main Results:

  • Pruritus is more prevalent in kidney disease patients than commonly recognized.
  • Understanding of pruritus pathogenesis has advanced, though some aspects require further investigation.
  • The first medication specifically for uremic pruritus, difelikefalin, was approved in the US in August 2021.

Conclusions:

  • Increased recognition of pruritus in nephrology is leading to better diagnosis and management.
  • Advances in research are paving the way for more effective treatments.
  • Focus on patient-reported symptoms like pruritus is crucial in modern nephrology care.