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Pruritus in Dialysis Patients 如何改善透析病人搔癢症

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Pruritus in Dialysis Patients 如何改善透析病人搔癢症

2025/1/14

Itchiness has been the most common and frustrating problem in uremic patients. About 60% of dialysis patients have itching problem. Current research shows that the causes of itch are numerous and complicated.

Causes

  • Hyperparathyroidism.
  • High levels of phosphorus and calcium in the blood; dry skin.
  • Dialysis inadequacy related accumulation of uremic toxin.
  • Anemia, iron deficiency.
  • Sweat gland hypofunction.
  • Side effects of medications and allergies, such as heparin, disinfecting agents and tape allergies.
  • Allergy to artificial kidney disinfectant or material.

Treatment

  • Adequate dialysis, increased blood flow, dialysis duration, and artificial kidney size.
  • Low-phosphorus diets and phosphor-binding drugs are used to reduce blood phosphorus to improve itching, while active vitamin D can low down the levels of parathyroid hormone.
  • The usage of erythropoietin has been shown to improve anemia, or itching.
  • Don't take too hot showers; cotton clothing is recommended; apply moisturizer to keep skin moist.
  • Improve itchy skin by taking or applying antipruritic drugs as prescribed by your doctor, or going to the dermatology clinic.
  • Use a cold towel to wipe and cool the skin or take low-temperature dialysis.
  • Change the type of heparin and review the suitability of artificial kidney or disinfectant (except peritoneal dialysis). In a few dialysis cases, itchy skin may be associated with allergies to the anticoagulant heparin, artificial kidney or disinfectant.
Reference
  • 王裕方、廖建富、陳明新、陳瑋毅、戴有志、呂秉勳(2022).尿毒搔癢症治療之系統性回顧.台灣醫學,26(3),271-286。https://doi.org/10.6320/FJM.202205_26(3).0002
  • Simonsen, E., Komenda, P., Lerner, B., Askin, N., Bohm, C., Shaw, J., Tangri, N., & Rigatto, C. (2017). Treatment of Uremic Pruritus: A Systematic Review. American journal of kidney diseases: the official journal of the National Kidney Foundation70(5), 638–655. https://doi.org/10.1053/j.ajkd.2017.05.018
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