How is pruritus in end-stage renal disease (ESRD) treated?

Updated: Mar 05, 2020
  • Author: Julia R Nunley, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Answer

Therapeutic options, which are inconsistently helpful, include emollients to alleviate xerosis, augmentation of dialysis efficacy, normalization of serum calcium and phosphate levels, and parathyroidectomy. For some, sedating antihistamines and sauna therapy may provide temporary relief. Nonsedating antihistamines and topical steroids usually are not helpful.

Ultraviolet (UV) B phototherapy probably is the most effective therapeutic choice and may have prolonged benefit. Options such as cholestyramine and activated charcoal may decrease absorption of essential nutrients, perhaps making them more detrimental than beneficial. Although conflicting data exist, some clinical studies have suggested that opiate-receptor antagonists, such as naloxone and naltrexone, may ameliorate pruritus in some dialysis patients.


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