Department of Internal Medicine, Diabetology and Nephrology, Zabrze, Medical University of Silesia, Katowice, Poland.
Med Sci Monit. 2013 Sep 2;19:723-32. doi: 10.12659/MSM.889349.
Uremic pruritus is a common complication in patients undergoing dialysis. The pathophysiological mechanisms of pruritus in patients with end-stage renal disease remain unknown. Neuropeptides, including substance P, are postulated to play an important role in the pathogenesis of pruritus. The aim of this study was to evaluate the role of substance P in uremic pruritus in patients on hemodialysis and peritoneal dialysis.
MATERIAL/METHODS: We included 197 patients with end-stage renal disease: 54 on continuous ambulatory peritoneal dialysis and 143 on hemodialysis. Substance P, calcium, phosphorus, iron, ferritin, CRP, albumin, hemoglobin, Ca×P product, and iPTH level were determined in all participants. The correlation between these parameters and self-reported itching was evaluated in patients on hemodialysis in comparison with peritoneal dialysis patients.
The incidence of itching was similar in hemodialysis and peritoneal dialysis patients. No differences in substance P level between the 2 groups were found. There was no correlation between substance P level and the incidence or intensity of pruritus in dialyzed patients.
This study demonstrates that substance P does not play any important role in pruritus in hemodialysed and peritoneal dialyzed patients. However, further studies are necessary to assess the exact role of neuropeptides in uremic pruritus.
尿毒症瘙痒是透析患者常见的并发症。终末期肾病患者瘙痒的病理生理机制尚不清楚。神经肽，包括 P 物质，被认为在瘙痒的发病机制中起重要作用。本研究旨在评估 P 物质在血液透析和腹膜透析患者尿毒症瘙痒中的作用。
材料/方法：我们纳入了 197 名终末期肾病患者：54 名持续不卧床腹膜透析患者和 143 名血液透析患者。所有参与者均测定 P 物质、钙、磷、铁、铁蛋白、CRP、白蛋白、血红蛋白、Ca×P 产物和 iPTH 水平。评估血液透析患者与腹膜透析患者之间这些参数与自我报告瘙痒之间的相关性。
血液透析和腹膜透析患者瘙痒的发生率相似。两组之间 P 物质水平无差异。在透析患者中，P 物质水平与瘙痒的发生率或强度之间无相关性。
本研究表明 P 物质在血液透析和腹膜透析患者的瘙痒中不起重要作用。然而，需要进一步研究来评估神经肽在尿毒症瘙痒中的确切作用。
