Schricker Severin, Kimmel Martin
Department of General Internal Medicine and Nephrology, Robert-Bosch-Hospital, Stuttgart, Germany.
Department of Internal Medicine, Division of Nephrology, Hypertension and Autoimmune Disorders, Alb-Fils Kliniken, Göppingen, Germany.
Clin Kidney J. 2021 Dec 24;14(Suppl 3):i23-i31. doi: 10.1093/ckj/sfab200. eCollection 2021 Dec.
For decades, itch related to chronic kidney disease (CKDaP) has been a clinical problem, but the aetiology and pathophysiology of CKDaP are still not yet fully understood-currently the underlying pathophysiological mechanisms are thought to be multifactorial. As new therapeutic targets have recently been identified and clinical trials have shown promising results, our current understanding of the interrelationships has expanded significantly. Here we review the pathophysiology and recent findings on modulation and sensitization of itch contributing to the development of CKDaP, covering hypothesis regarding immune system dysfunction, metabolic changes, uremic toxin deposition, peripheral neuropathy and imbalances in the endogenous opioid system.
几十年来，与慢性肾脏病相关的瘙痒（CKDaP）一直是一个临床问题，但CKDaP的病因和病理生理学仍未完全明确——目前认为其潜在的病理生理机制是多因素的。随着最近新的治疗靶点被确定，且临床试验显示出有前景的结果，我们目前对其中相互关系的理解有了显著扩展。在此，我们综述了导致CKDaP发生的瘙痒调节和敏化的病理生理学及最新发现，涵盖了关于免疫系统功能障碍、代谢变化、尿毒症毒素沉积、周围神经病变以及内源性阿片系统失衡的假说。
