Pruritus in Uremic Patients: Approaches to Alleviating a Common Symptom in Chronic Kidney Disease

Chronic kidney disease-associated pruritus (CKD-aP) is a distressing symptom that affects both dialysis and non-dialysis patients, significantly impairing their quality of life. Despite its multifactorial pathophysiology, no gold-standard treatment has been established. This review explores various...

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Main Authors: Ștefania Cîrstea, Olguța Anca Orzan, Diana Silvia Zilișteanu
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Life
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Online Access:https://www.mdpi.com/2075-1729/15/7/1001
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author Ștefania Cîrstea
Olguța Anca Orzan
Diana Silvia Zilișteanu
author_facet Ștefania Cîrstea
Olguța Anca Orzan
Diana Silvia Zilișteanu
author_sort Ștefania Cîrstea
collection DOAJ
description Chronic kidney disease-associated pruritus (CKD-aP) is a distressing symptom that affects both dialysis and non-dialysis patients, significantly impairing their quality of life. Despite its multifactorial pathophysiology, no gold-standard treatment has been established. This review explores various therapeutic options and evaluates their effectiveness based on recent clinical studies and meta-analyses. Therapies targeting novel mechanisms have evolved in recent years. Difelikefalin, a κ-opioid receptor agonist, represents a breakthrough in systemic treatment, demonstrating efficacy with a favorable safety profile. Another opioid-based therapy, nalfurafine, has shown notable symptom relief in multiple clinical studies, with a low risk of abuse. Sertraline, an antidepressant, offers another alternative, although its delayed onset remains a limitation. Nonpharmacologic approaches are also evolving. Phototherapy, particularly UV-B therapy, modulates the immune response, reduces inflammation, and effectively alleviates itching in hemodialysis patients. Personalized treatment strategies are crucial, as responses vary among patients. Further research, including comparative and long-term studies, is essential to refine treatment algorithms and improve patient outcomes. By integrating new pharmacologic and nonpharmacologic options, CKD-aP management is shifting toward a more tailored and effective approach that addresses the individual needs of each patient.
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spelling doaj-art-36ae01b7e2f94ffc98e9d10a756281502025-08-20T03:07:55ZengMDPI AGLife2075-17292025-06-01157100110.3390/life15071001Pruritus in Uremic Patients: Approaches to Alleviating a Common Symptom in Chronic Kidney DiseaseȘtefania Cîrstea0Olguța Anca Orzan1Diana Silvia Zilișteanu2Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, RomaniaFaculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, RomaniaFaculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, RomaniaChronic kidney disease-associated pruritus (CKD-aP) is a distressing symptom that affects both dialysis and non-dialysis patients, significantly impairing their quality of life. Despite its multifactorial pathophysiology, no gold-standard treatment has been established. This review explores various therapeutic options and evaluates their effectiveness based on recent clinical studies and meta-analyses. Therapies targeting novel mechanisms have evolved in recent years. Difelikefalin, a κ-opioid receptor agonist, represents a breakthrough in systemic treatment, demonstrating efficacy with a favorable safety profile. Another opioid-based therapy, nalfurafine, has shown notable symptom relief in multiple clinical studies, with a low risk of abuse. Sertraline, an antidepressant, offers another alternative, although its delayed onset remains a limitation. Nonpharmacologic approaches are also evolving. Phototherapy, particularly UV-B therapy, modulates the immune response, reduces inflammation, and effectively alleviates itching in hemodialysis patients. Personalized treatment strategies are crucial, as responses vary among patients. Further research, including comparative and long-term studies, is essential to refine treatment algorithms and improve patient outcomes. By integrating new pharmacologic and nonpharmacologic options, CKD-aP management is shifting toward a more tailored and effective approach that addresses the individual needs of each patient.https://www.mdpi.com/2075-1729/15/7/1001prurituschronic kidney diseaseuremic patienturemic pruritus
spellingShingle Ștefania Cîrstea
Olguța Anca Orzan
Diana Silvia Zilișteanu
Pruritus in Uremic Patients: Approaches to Alleviating a Common Symptom in Chronic Kidney Disease
Life
pruritus
chronic kidney disease
uremic patient
uremic pruritus
title Pruritus in Uremic Patients: Approaches to Alleviating a Common Symptom in Chronic Kidney Disease
title_full Pruritus in Uremic Patients: Approaches to Alleviating a Common Symptom in Chronic Kidney Disease
title_fullStr Pruritus in Uremic Patients: Approaches to Alleviating a Common Symptom in Chronic Kidney Disease
title_full_unstemmed Pruritus in Uremic Patients: Approaches to Alleviating a Common Symptom in Chronic Kidney Disease
title_short Pruritus in Uremic Patients: Approaches to Alleviating a Common Symptom in Chronic Kidney Disease
title_sort pruritus in uremic patients approaches to alleviating a common symptom in chronic kidney disease
topic pruritus
chronic kidney disease
uremic patient
uremic pruritus
url https://www.mdpi.com/2075-1729/15/7/1001
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AT olgutaancaorzan pruritusinuremicpatientsapproachestoalleviatingacommonsymptominchronickidneydisease
AT dianasilviazilisteanu pruritusinuremicpatientsapproachestoalleviatingacommonsymptominchronickidneydisease