Itching: this is the unknown and harsh symptom of chronic kidney disease

Itching from morning to night. This is what five out of ten patients with in Spain (CKD) suffer.

These patients scratch continuously due to pruritus, a sensation or symptom that manifests as unpleasant itching that induces scratching of the skin.

And although it might seem like a minor issue, this unpleasant and continuous sensation can cause a significant reduction in the quality of life of kidney patients who suffer from it.

Until recently, there were no real data on this relationship between Chronic Kidney Disease and pruritus in Spain, but a study carried out by the has yielded scientific data.

And these confirm the significant negative impact it has on these patients, who come to develop:

• Sleep disorders

• Distress

• Depression

• mood swings

• Even an affectation of his sexual life.

How do you explain the Dr. Patricia de Sequerapresident of the Spanish Society of Nephrology (SEN):

• “Until now there was no real approximation of itching in CKD patients in Spain, most of whom do not know why they have that sensation of continuous scratching. This study has allowed us not only to carry out the first record of data on associated pruritus to CKD in the world, but to learn more about this problem, so that we can establish measures and actions to improve its treatment and the quality of life of the people who suffer from it, thus reducing the impact it has on them”.

50% of patients with chronic kidney disease suffer from itching all over the body and at any time of the day, especially at night.

Half of patients with chronic kidney disease suffer from itching

The results of this study are compelling.

Of a total of 1,605 patients with CKD, 50% suffered from pruritus. And of them, 26.7% suffer from it in a moderate to severe way.

This means that all these people suffer from itching all over their bodies and at any time of the day. And the worst thing is that the frequency of itching increases during the night

The direct consequence is that it seriously affects their health and quality of life, causing major disorders such as:

• Mood swings.

• Sleep problems (restless sleep, taking medication to fall asleep).

• The anguish.

• The lack of rest.

• Depression.

And not only that. Research on pruritus in these patients also found a significant influence on sexual function and reduced sexual desire as the severity of pruritus-associated CKD increased.

On the other hand, the prevalence of pruritus was higher in patients with advanced CKD without dialysis, suggesting a benefit in reducing itching in these patients.

Difficult diagnosis and treatment

The pruritus associated with Chronic Kidney Disease is a frequent sensation in renal patients, although the prevalence was unknown due to the high percentage of underdiagnosis.

In fact, the prevalence of this pruritus found in different studies to date ranged between 40 and 90% in hemodialysis patients, and between 19 and 29% in non-dialysis patients. These data have now been updated with the study carried out by the SEN

As for the causes of this itching associated with CKD, there is still no clear explanation, which makes it very difficult to find an effective treatment.

Itching can cause a significant reduction in the quality of life of kidney patients who suffer from it.

Pruritus can have many causes and its origin is multifactorial: toxins from the body that are not eliminated well in hemodialysis, having altered calcium and phosphorus levels, suffering an alteration in opioid receptors in the skin, etc.

To the point that, as explained by the doctor Emilio J. Sanchezcoordinator of SEN registries and one of those responsible for the study, together with the Dr. Nuria Arestenephrologist at the Virgen Macarena University Hospital in Seville.

• “All of this makes us nephrologists feel, at times, frustrated at not being able to solve this problem. Neither do patients identify chronic kidney disease as a pathology related to their pruritus, so it is not uncommon for them not to transmit this symptom to the professionals , making its diagnosis and how to act more difficult”.

Recommendations to reduce itching

In addition, there is currently no specific treatment for pruritus, only various health recommendations and advice to improve skin hydration, including:

• Drink more water, although this option is limited to patients who maintain diuresis (ability to urinate).

• Use moisturizing creams.

• Taking antihistamine or gabapentinoid medications

• Perform phototherapy.

“Despite the fact that pruritus has a negative impact on quality of life and can negatively affect clinical outcomes and increase the risk of mortality in these patients, some nephrologists and specialists still tend to underestimate the number of patients with this symptom, and in some cases they do not know clearly that these serious consequences can be caused by it”, says Dr. Emilio J. Sánchez.