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Comparison of combined blood purification techniques in treatment of dialysis patients with uraemic pruritus

time :  2017-03-02

Jing Zhang, Yanggang Yuan, Xiaofei An, Chun Ouyang, Haibin Ren, Guang Yang, Xiangbao Yu, Xiaolin Lv, Bo Zhang, Ningning Wang, Huijuan Mao, Yamei Zhu, Changying Xing

Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China; 2Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China. 

*Equal contributors.

Received November 13, 2015; Accepted April 8, 2016; Epub May 15, 2016; Published May 30, 2016

Abstract: Uremic pruritus affects many patients suffering from end-stage renal disease (ESRD) and has a negative impact on quality of life and survival. The aim of this study was to investigate the treatment effects of different combined blood purification techniques on uremic pruritus in ESRD patients. Forty maintenance hemodialysis patients with uremic pruritus were selected and randomly divided into combined treatment of hemodialysis with hemoperfusion group (HP+HD) and combined treatment of hemodiafiltration with hemoperfusion group (HP+HDF). Some relevant clinical parameters (age, gender, duration of dialysis, ESRD etiology, hemoglobin, albumin, and C-reactive protein) were evaluated. Blood urea nitrogen (BUN), creatinine, phosphate, parathyroid hormone (PTH) and β2-microglobulin were tested before and after treatment. A visual analogue scale (VAS) was used to assess the intensity of pruritus. The results showed that BUN, serum creatinine, phosphates, PTH and β2-microglobulin were significantly decreased after the therapy in the two groups (P<0.05). A more significant decrease (P<0.05) was observed in HP+HDF group as compared with HP+HD group. After 12 weeks of treatment, there were also significant differences in pruritus scores in HP+HD group and HP+HDF group. The pruritus remission rates in the HP+HD and HP+HDF groups were 75% and 100%, respectively. Therefore, our findings suggest a potential role for HP+HDF in the treatment of uremic pruritus.

Keywords: Uremia, pruritus, hemoperfusion, hemodialysis, hemodiafiltration

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