Pruritus is a very common chronic and frustrating symptom that considerably affects the quality of life of patients with end-stage renal disease. The current review examined the updates in the epidemiology, pathophysiology, and management of uraemic pruritus. Recently, there has been reduction in the prevalence of uraemic pruritus. With few exceptions, there have been no significant differences in the prevalence of uraemic pruritus by age, gender, and type of dialysis. However, pre-dialysis prevalence was lower than during dialysis prevalence. In recent years, new pathophysiologic hypotheses (immune and opioid) have been postulated and other hypotheses have been undermined (serotonin). There have been several anti-pruritic therapies examined among hemodialysis patients, including efficient dialysis, topical medications, systemic medications, physical and alternative treatments, and surgical treatments. However, none is considered the drug of choice or exclusively efficient in all patients. Several new medications have been examined in the last decade. However, for many of these medications, the evidence is still insufficient for their recommendations. After all advances in dialysis techniques and the availability of multiple therapies, uraemic pruritus is still a significant problem among hemodialysis patients that warrant further research.
Key words: Pruritus, uremia, kidney failure, renal dialysis, drug therapy
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