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中华肾病研究电子杂志 ›› 2023, Vol. 12 ›› Issue (06) : 334 -338. doi: 10.3877/cma.j.issn.2095-3216.2023.06.006

综述

维持性血液透析患者皮肤瘙痒症的发病机制及治疗研究进展
许厅, 熊智倩, 刘俪婷, 姜燕, 苏朝江, 刘宗旸()   
  1. 550004 贵阳,贵州医科大学临床医学院
    550003 贵阳,贵州医科大学附属肿瘤医院肾内科
  • 收稿日期:2023-05-16 出版日期:2023-12-28
  • 通信作者: 刘宗旸
  • 基金资助:
    贵州省卫生健康委科学技术基金项目(gzwkj2022-325)

Research progress on the pathogenesis and treatment of pruritus in maintenance hemodialysis patients

Ting Xu, Zhiqian Xiong, Liting Liu, Yan Jiang, Chaojiang Su, Zongyang Liu()   

  1. Clinical Medical College of Guizhou Medical University, Guiyang 550004
    Departmengt of Nephrology, Cancer Hospital Affiliated to Guizhou Medical University, Guiyang 550003; Guizhou Province, China
  • Received:2023-05-16 Published:2023-12-28
  • Corresponding author: Zongyang Liu
引用本文:

许厅, 熊智倩, 刘俪婷, 姜燕, 苏朝江, 刘宗旸. 维持性血液透析患者皮肤瘙痒症的发病机制及治疗研究进展[J/OL]. 中华肾病研究电子杂志, 2023, 12(06): 334-338.

Ting Xu, Zhiqian Xiong, Liting Liu, Yan Jiang, Chaojiang Su, Zongyang Liu. Research progress on the pathogenesis and treatment of pruritus in maintenance hemodialysis patients[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2023, 12(06): 334-338.

皮肤瘙痒症是维持性血液透析患者的常见并发症之一,临床发病率高,可造成患者焦虑、抑郁和睡眠障碍,增加患者的死亡风险。虽然维持性血液透析患者皮肤瘙痒症的病因复杂、尚未明确,但随着医疗技术水平的不断发展,药物、理疗、手术等多种治疗方式可以缓解皮肤瘙痒症状,改善患者的生活质量。本文对维持性血液透析患者皮肤瘙痒症发病机制及治疗的研究进展进行了综述。

Pruritus is one of the common complications of maintenance hemodialysis patients. It has a high clinical incidence, and can cause anxiety, depression, and sleep disorders, increasing the risk of mortality in the patients. Although the etiology of pruritus in maintenance hemodialysis patients is complex and unclear yet, with the continuous development of medical technology, various treatment methods have been developed to alleviate the symptoms and improve the quality of life of patients, including medication, physical therapy, and surgery, etc. This article mainly reviewed the progress of research on the pathogenesis and treatment of pruritus in maintenance hemodialysis patients.

图1 维持性血液透析患者皮肤症的发病机制及治疗模式图
[1]
Cheng AY, Wong LS. Uremic pruritus: from diagnosis to treatment [J]. Diagnostics (Basel), 2022, 12(5): 1108.
[2]
Sukul N, Karaboyas A, Csomor PA, et al. Self-reported pruritus and clinical, dialysis-related, and patient-reported outcomes in hemodialysis patients [J]. Kidney Med, 2020, 3(1): 42-53.
[3]
Agarwal P, Garg V, Karagaiah P, et al. Chronic kidney disease-associated pruritus [J]. Toxins, 2021, 13(8): 527.
[4]
Verduzco HA, Shirazian S. CKD-associated pruritus: new insights into diagnosis, pathogenesis, and management [J]. Kidney Int Rep, 2020, 5(9): 1387-1402.
[5]
王一梅,丁小强,陈利明,等. 190例血液透析患者皮肤瘙痒的临床研究[J]. 复旦学报(医学版), 2007, (2): 292-295.
[6]
Attia EAS, Hassan AA. Uremic pruritus pathogenesis, revisited. [J]. Arab J Nephrol Transplant, 2014, 7(2): 91-96.
[7]
Sorour NE, Elesawy FM, Tabl HA, et al. Evaluation of serum levels of neurotrophin 4 and brain-derived nerve growth factor in uremic pruritus patients [J]. Clin Cosmet Investig Dermatol, 2019, 12: 109-114.
[8]
Wieczorek A, Krajewski P, Kozioł-Gałczyńska M, et al. Opioid receptors expression in the skin of haemodialysis patients suffering from uraemic pruritus [J]. J Eur Acad Dermatol Venereol, 2020, 34(10): 2368-2372.
[9]
王楠,林洪丽. 透析模式对血液透析患者预后影响的思考[J]. 中国实用内科杂志2021, 41(11): 926-930.
[10]
Reszke R, Kilis-Pstrusińska K, Szepietowski JC. Chronic kidney disease-associated itch (CKD-aI) in children-a narrative review [J]. Toxins (Basel), 2021, 13(7): 450.
[11]
Weisshaar E, Szepietowski JC, Dalgard FJ, et al. European S2k guideline on chronic pruritus [J]. Acta Derm Venereol, 2019, 99(5): 469-506.
[12]
Tang Y, Cheng S, Wang J, et al. Acupuncture for the treatment of itch: peripheral and central mechanisms [J]. Front Neurosci, 2022, 15: 786892.
[13]
Xiong W, He FF, You RY, et al. Acupuncture application in chronic kidney disease and its potential mechanisms [J]. Am J Chin Med, 2018, 46(6): 1169-1185.
[14]
刘东,高卓,魏学明,等. 甲状旁腺切除治疗尿毒症继发性甲状旁腺功能亢进症患者皮肤瘙痒的临床观察[J]. 中国血液净化2014, 13(3): 134-136.
[15]
Martin CE, Clotet-Freixas S, Farragher JF, et al. Have we just scratched the surface? A narrative review of uremic pruritus in 2020 [J]. Can J Kidney Health Dis, 2020, 7: 2054358120954024.
[16]
Krajewski PK, Olczyk P, Krajewska M, et al. Clinical characteristics of itch in renal transplant recipients [J]. Front Med (Lausanne), 2021, 7: 615334.
[17]
Teo WY, Chu SWF, Chow LY, et al. Role of alternative medical systems in adult chronic kidney disease patients: a systematic review of literature [J]. Cureus, 2022, 14(12): e32874.
[18]
Makhlough A, Ala S, Haj-Heydari Z, et al. Topical capsaicin therapy for uremic pruritus in patients on hemodialysis [J]. Iran J Kidney Dis, 2010, 4(2): 137-140.
[19]
Venkataramanan R, Swaminathan A, Prasad T, et al. Clinical pharmacokinetics of tacrolimus [J]. Clin Pharmacokinet, 1995, 29(6): 404-430.
[20]
Chen YC, Chiu WT, Wu MS. Therapeutic effect of topical gamma-linolenic acid on refractory uremic pruritus [J]. Am J Kidney Dis, 2006, 48(1): 69-76.
[21]
Szepietowski JC, Szepietowski T, Reich A. Efficacy and tolerance of the cream containing structured physiological lipids with endocannabinoids in the treatment of uremic pruritus: a preliminary study [J]. Acta Dermatovenerol Croat, 2005, 13(2): 97-103.
[22]
张萍,宋小炜,杨丽南,等. 丝胶蛋白对维持性血液透析患者尿毒症性瘙痒疗效的研究[J]. 西南国防医药2017, 27(3): 221-223.
[23]
Kobayashi K, Endoh F, Ohmori I, et al. Action of antiepileptic drugs on neurons [J]. Brain Dev, 2020, 42(1): 2-5.
[24]
Eusebio-Alpapara KMV, Castillo RL, Dofitas BL. Gabapentin for uremic pruritus: a systematic review of randomized controlled trials [J]. Int J Dermatol, 2020, 59(4): 412-422.
[25]
Ravindran A, Kunnath RP, Sunny A, et al. Comparison of safety and efficacy of pregabalin versus gabapentin for the treatment of uremic pruritus in patients with chronic kidney disease on maintenance haemodialysis [J]. Indian J Palliat Care, 2020, 26(3): 281-286.
[26]
Zhang P, Xiang S, Liu B, et al. Randomized controlled trial of nalfurafine for refractory pruritus in hemodialysis patients [J]. Ren Fail, 2023, 45(1): 2175590.
[27]
Wala K, Szepietowski JC. Difelikefalin in the treatment of chronic kidney disease-associated pruritus: a systematic review [J]. Pharmaceuticals (Basel), 2022, 15(8): 934.
[28]
Fishbane S, Jamal A, Munera C, et al. A phase 3 trial of difelikefalin in hemodialysis patients with pruritus [J]. N Engl J Med, 2020, 382(3): 222-232.
[29]
Peer G, Kivity S, Agami O, et al. Randomised crossover trial of naltrexone in uraemic pruritus [J]. Lancet, 1996, 348(9041): 1552-1554.
[30]
Pauli-Magnus C, Mikus G, Alscher DM, et al. Naltrexone does not relieve uremic pruritus: results of a randomized, double-blind, placebo-controlled crossover study [J]. J Am Soc Nephrol, 2000, 11(3): 514-519.
[31]
Mathur VS, Kumar J, Crawford PW, et al. A multicenter, randomized, double-blind, placebo-controlled trial of nalbuphine ER tablets for uremic pruritus [J]. Am J Nephrol, 2017, 46(6): 450-458.
[32]
Pakfetrat M, Malekmakan L, Hashemi N, et al. Sertraline can reduce uremic pruritus in hemodialysis patient: a double blind randomized clinical trial from Southern Iran [J]. Hemodial Int, 2018, 22(1): 103-109.
[33]
Mettang T, Krumme B, Bohler J, et al. Pentoxifylline as treatment for uraemic pruritus--an addition to the weak armentarium for a common clinical symptom? [J]. Nephrol Dial Transplant, 2007, 22(9): 2727-2728.
[34]
Hercz D, Jiang SH, Webster AC. Interventions for itch in people with advanced chronic kidney disease [J]. Cochrane Database Syst Rev, 2020, 12(12): CD011393.
[35]
Forouhari A, Moghtaderi M, Raeisi S, et al. Pruritus-reducing effects of omega-3 fatty acids in hemodialysis patients: a cross-over randomized clinical trial [J]. Hemodial Int, 2022, 26(3): 408-414.
[36]
Cupisti A, Piccoli GB, Gallieni M. Charcoal for the management of pruritus and uremic toxins in patients with chronic kidney disease [J]. Curr Opin Nephrol Hypertens, 2020, 29(1): 71-79.
[37]
禤晓燕,李杰峰,梁子安,等. 硫代硫酸钠治疗维持性血液透析患者皮肤瘙痒的研究 [J]. 黑龙江医学2019, 43(5): 474-475.
[38]
Song YH, Wang SY, Lang JH, et al. Therapeutic effect of intravenous sodium thiosulfate for uremic pruritus in hemodialysis patients [J]. Ren Fail, 2020, 42(1): 987-993.
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