Dialysis and Mineral and Bone Parameters
Traditionally when itch is present, clinicians look toward abnormalities in calcium, phosphate, and parathyroid hormone (PTH). It is true that some studies have shown correlations between these parameters and itch severity and there are rare reports of improvement after parathyroidectomy. However, in clinical practice it is unlikely that disorders of mineral and bone disease have any significant role in most cases of CKD-aP. In a longitudinal study, there was no relationship between changes in itch over time and any of these parameters. Similarly, in an influential study of 23 000 hemodialysis patients by Sukul et al. there was no relationship between the degree of itch and any of these parameters. In contrast, uremia itself or significant underdialysis are an accepted cause of itch and should be corrected if present.
Curr Opin Nephrol Hypertens. 2022;31(5):435-441. © 2022 Lippincott Williams & Wilkins