Chronic kidney disease-associated pruritus: what is known and its application in children

Pediatr Nephrol. 2024 Jan;39(1):25-35. doi: 10.1007/s00467-023-05998-8. Epub 2023 May 12.

Abstract

Chronic kidney disease-associated pruritus (CKD-aP) or uremic pruritus (UP) is a frequent symptom in patients with kidney failure receiving kidney replacement therapy. Severe chronic kidney disease-associated pruritus correlates with poor outcome in patients on dialysis. It is multifactorial in etiology and has a significant impact on quality of life. There is, however, limited data for children. This review summarizes current epidemiology, clinical characteristics, pruritus scoring systems, and available therapeutic options for pruritus in patients with chronic kidney disease and those receiving dialysis. Optimal care requires proper awareness of the severity of symptoms, the impact on quality of life, and the possible long-term outcomes. Optimizing dialysis prescription and correcting electrolyte abnormalities are important treatment targets. A wide range of therapeutic options is also available although none are well-studied in children. An earlier recognition of this debilitating symptom in children and treatment is imperative. A higher resolution version of the Graphical abstract is available as Supplementary information.

Keywords: Hemodialysis; Kidney failure; Peritoneal dialysis; Pruritus; Visual analog scale.

Publication types

  • Review

MeSH terms

  • Child
  • Humans
  • Pruritus / diagnosis
  • Pruritus / epidemiology
  • Pruritus / etiology
  • Quality of Life
  • Renal Dialysis* / adverse effects
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / epidemiology
  • Renal Insufficiency, Chronic* / therapy