Elhag Sayed, Rivas Nancy, Tejovath Sreedevi, Mustaffa Nadiah, Deonarine Nadira, Abdullah Hashmi Muzaffar, Yerneni Sindhura, Hamid Pousette
Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2022 Jan 11;14(1):e21127. doi: 10.7759/cureus.21127. eCollection 2022 Jan.
Chronic kidney disease-associated pruritus (CKD-aP), also known as uremic pruritus, has been associated with increased mortality and lower quality of life among patients with chronic kidney disease (CKD). The relentless nature of the condition is mainly due to its diverse and complex etiologies, which are still being studied. Despite the introduction of many agents to treat it, the resolution rates of CKD-aP still remain unsatisfactory. This study sought to review the lesser-known/novel treatments and establish a relationship between their mechanism of action and the proposed etiologies implicated in CKD-aP. We also discuss the role of dialysis modification in managing CKD-aP. A decent proportion of the reviewed studies have proposed that the agents analyzed in them act through hampering inflammation. Interestingly, the results of two agents alluded to the role of dysbiosis in CKD-aP. The addition of hemoperfusion to the dialysis regimen of patients with CKD-aP improved the severity of their symptoms. The featured treatments could be tried in patients with intractable symptoms. However, additional research is needed to confirm the findings reported in these studies. A better understanding of the pathologic mechanisms is required to help guide the development of agents that can better treat CKD-aP.
慢性肾脏病相关性瘙痒（CKD-aP），也称为尿毒症性瘙痒，与慢性肾脏病（CKD）患者死亡率增加及生活质量降低有关。该病症的持续性主要归因于其多样且复杂的病因，目前仍在研究中。尽管已引入多种药物进行治疗，但CKD-aP的缓解率仍不尽人意。本研究旨在回顾鲜为人知的/新型治疗方法，并建立其作用机制与CKD-aP相关病因之间的联系。我们还讨论了透析调整在管理CKD-aP中的作用。相当一部分综述研究提出，其中分析的药物通过抑制炎症起作用。有趣的是，两种药物的结果暗示了菌群失调在CKD-aP中的作用。在CKD-aP患者的透析方案中增加血液灌流可改善其症状严重程度。对于症状难治的患者，可以尝试这些特色治疗方法。然而，需要更多研究来证实这些研究报告的结果。需要更好地了解病理机制，以帮助指导开发能够更好治疗CKD-aP的药物。
