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Chronic kidney disease-associated pruritus: what is known and its application in children

Shweta Shah1, Elizabeth Onugha2, Sarah J Swartz2

  • 1Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA. ssshah@texaschildrens.org.

Pediatric Nephrology (Berlin, Germany)
|May 12, 2023
PubMed

Insights

Chronic kidney disease-associated pruritus (CKD-aP), or uremic pruritus, significantly impacts dialysis patients. Early recognition and treatment in children are crucial due to limited data and available therapies.

Area of Science:

  • Nephrology
  • Dermatology
  • Pediatrics

Background:

  • Chronic kidney disease-associated pruritus (CKD-aP), also known as uremic pruritus, is a common and severe symptom in patients with kidney failure undergoing kidney replacement therapy.
  • Severe pruritus in dialysis patients is linked to adverse outcomes and significantly diminishes quality of life.
  • Limited data exists regarding CKD-aP specifically in pediatric populations.

Purpose of the Study:

  • To review the current understanding of CKD-aP epidemiology, clinical features, assessment tools, and treatment options.
  • To highlight the importance of recognizing and managing pruritus in children with chronic kidney disease.
  • To emphasize the need for better-studied therapeutic interventions for pediatric CKD-aP.

Main Methods:

  • Literature review of epidemiology, clinical characteristics, pruritus scoring systems, and therapeutic options for CKD-aP.
  • Focus on data relevant to patients with chronic kidney disease and those on dialysis.
  • Specific attention to the pediatric population and the scarcity of research therein.

Main Results:

  • CKD-aP is multifactorial, impacts quality of life, and correlates with poor outcomes in dialysis patients.
  • Optimizing dialysis and correcting electrolyte imbalances are key management strategies.
  • A range of treatments exist, but few are well-studied in children.

Conclusions:

  • Optimal management of CKD-aP requires awareness of symptom severity and impact on quality of life.
  • Earlier recognition and treatment of pruritus in children with chronic kidney disease are imperative.
  • Further research is needed to establish effective and well-studied treatments for pediatric CKD-aP.

Keywords:
HemodialysisKidney failurePeritoneal dialysisPruritusVisual analog scale

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