Benchikhi H, Moussaid L, Doukaly O, Ramdani B, Zaid D, Lakhdar H
Service de dermatologie, CHU Ibn Rochd, Casablanca, Maroc.
Nephrologie. 2003;24(3):127-31.
The prevalence of pruritus varies from 60% to 90% in patients receiving hemodialysis. The aim to this study was to evaluate the frequency of pruritus and its characteristics among moroccan patients receiving hemodialysis. Pruritus related to primary skin disease or other identified cause than chronic renal failure was excluded. Biological parameters were compared between patients with pruritus and those without. Pruritus occurred in 74.4% of hemodialysis patients and concerned 66 men and 68 women, mean age 44.8 + 14 years. Duration of hemodialysis varied between 5 months to 10 years. Main characteristics of pruritus were a general pattern in 70%, moderate intensity in 50%, appearance after dialysis in 81.2% and severe psychologic repercussion in 20.8%. Antihistamines first-line treatment was rarely effective. UVB radiation used in 7 cases leaded to a marked improvement. This study underlined the high frequency of pruritus in moroccan patients with chronic renal failure on maintenance hemodialysis. Hemodialysis can initiate this symptom as well as improve it. Biological parameters were not different between patients with or without pruritus. It also pointed out on therapeutic challenges. However, UVB radiation seems to be an effective therapy in intractable itching as well as increased frequency of weekly courses of hemodialysis. Long term skin hydratation should be also highly recommended.
接受血液透析的患者中瘙痒症的患病率在60%至90%之间。本研究的目的是评估摩洛哥接受血液透析患者中瘙痒症的发生率及其特征。排除与原发性皮肤病或除慢性肾衰竭以外其他已确定病因相关的瘙痒症。对有瘙痒症的患者和无瘙痒症的患者的生物学参数进行了比较。74.4%的血液透析患者出现瘙痒症，其中男性66例，女性68例，平均年龄44.8±14岁。血液透析时间在5个月至10年之间。瘙痒症的主要特征为：70%呈全身性，50%强度中等，81.2%在透析后出现，20.8%有严重的心理影响。一线治疗药物抗组胺药很少有效。7例患者使用紫外线B辐射后有明显改善。本研究强调了摩洛哥维持性血液透析的慢性肾衰竭患者中瘙痒症的高发生率。血液透析可引发此症状，也可改善此症状。有瘙痒症和无瘙痒症的患者生物学参数无差异。研究还指出了治疗方面的挑战。然而，紫外线B辐射似乎是治疗顽固性瘙痒以及增加每周血液透析次数的有效疗法。长期皮肤保湿也应大力推荐。
