ABSTRACT

Pruritus is a condition affecting about 40% of patients with end stage chronic kidney disease (CKD ). Although the severity of chronic pruritus individually varies, it is in general severe in uremic pruritus (UP) and significantly affects the quality of life of patients. As the etiology of UP is not clearly understood, there are many alternatives recommended for treatment. The aim of treatment is to reduce the severity of pruritus and to increase the quality of life of patients. Emollients, gabapentin and phototherapy are recommended as first line therapy in patients who are not suitable for kidney transplantation or who are at preparation stage. In patients refractory to these treatments, μ-opioid receptor antagonists such as naltrexone or κ-opioid receptor agonist such as nalfurafine can be preferred. Certain authors recommend adjuvant medicine and alternative treatments, however evidence level of these treatments is low. In patients who are refractory to all of these treatments, kidney transplantation as a precise and last treatment option in suitable patients. In this article, uremic pruritus and current treatment approaches are reviewed.