Do you have chronic kidney disease (CKD) and experience excessive and uncomfortable itching? This is a common symptom in the late stages of CKD, where it affects approximately one-third of dialysis patients. The medical term for it in CKD patients is uremic pruritus (UP). Learn more about UP, including the causes, signs, and treatment options.*

What Causes UP?

As CKD progresses, other parts of the body may experience change, leading to UP. Common causes of UP include:

• Dry skin
• Reduced sweating
• Accumulation of toxins
• Abnormal amounts of minerals in the body such as phosphorus, magnesium, and aluminum
• Sprouting of new nerves
• Inadequate dialysis
• Co-existing diseases, particularly diabetes and liver disease

What Are the Common Characteristics of UP?

The itchiness associated with UP often affects the back but can be felt anywhere, including the arms, head, and abdomen. The characteristics of UP are consistent among different skin types and ethnicities. 

Some characteristic features include:

• Intensified at night, often disrupting sleep
• Heat and stress worsen itchiness
• Relief felt with physical activity, cooler temperatures, and hot or cold showers
• Fluctuation of itchiness during dialysis 

What Are Treatment Options for UP?

UP has many treatment options available, and is broken into multiple categories, which are:

• General measures 
  • Use non-soap cleansers, and apply products to soften the skin (emollients)
  • Avoid scratching, and keep fingernails well-manicured and clean
• Topical 
  • Menthol cream provides a soothing, cooling sensation
  • Capsaicin, a cream made from chili peppers, stops the itch signal in your nerves
• Prescription medications
  • Gabapentin, a pain-reliever
  • Nalfurafine, an oral anti-itch drug
  • Difelikefalin, an injectable anti-itch drug
  • Additional options are also available
• Supplements
  • Zinc, which CKD patients are commonly deficient in 
  • Omega-3 fatty acids
• Alternative therapies
  • Acupuncture
  • Acupressure

Speak with your doctor before starting any treatment for UP. They can recommend or prescribe the ones that may be most effective for your body, given your health status and any sensitivities.

*Van Rooij, N. (2022, March). Uraemic Pruritus (Renal Itch). DermNet NZ. https://dermnetnz.org/topics/uraemic-pruritus

HealthyKidney Inc. (2021, February 11). Uremic pruritus (UP), Kidney Disease, and Itching. Home Remedies You Can Try Today [Video]. Retrieved from https://www.youtube.com/watch?v=8Nn6M1qGofg