Topical regimens for the management of uremic pruritus

Uremic pruritus (UP), also known as chronic kidney disease-associated pruritus, is a distressing condition affecting patients with end-stage renal disease. Characterized by persistent itching, it significantly impacts patients' quality of life, leading to sleep disturbances, emotional distress, and decreased overall well-being. Although the exact pathophysiology remains uncertain, immune dysregulation, reduced stratum corneum hydration, and altered neurogenic inflammation contribute to UP. Consequently, treating UP poses a significant challenge. Among therapeutic regimens, topical regimens have been shown to effectively alleviate UP. Various topical formulations, including urea-based, physiological lipids, natural oils, capsaicin, anesthetics and glycerin-containing emollients, have demonstrated benefits in amelioration of pruritic symptoms. Clinical studies suggest that consistent application of emollients can minimize skin dryness and relieve pruritus. This review summarizes key clinical findings on the topical therapeutic regimens for UP.