Progress in research of chronic kidney disease-related pruritus

doi:10.3877/cma.j.issn.1674-0785.2025.03.008

Abstract

Abstract:

The chronic kidney disease （CKD） population in China continues to grow，accompanied by an increasing number of CKD-related pruritus cases.This condition has emerged as a key clinical concern due to its marked impairment of life quality and elevated mortality risk.However，its pathological mechanisms and therapeutic options remain poorly understood.This article systematically reviews the pathogenesis and current therapeutic approaches for this condition，aiming to enhance clinical outcomes and improve patients' quality of life.

Key words: Chronic kidney disease-associated pruritus, Pathogenesis, Treatment methods

Peipei Xi, Jiajun Zhou. Progress in research of chronic kidney disease-related pruritus[J]. Chinese Journal of Clinicians(Electronic Edition), 2025, 19(03): 216-220.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhlcyszz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0785.2025.03.008

https://zhlcyszz.cma-cmc.com.cn/EN/Y2025/V19/I03/216

References 45

1	Verduzco HA，Shirazian S.CKD-associated pruritus： New insights into diagnosis，pathogenesis，and management ［J］.Kidney Int Rep，2020，5（9）： 1387-1402.
2	Rayner H C，Larkina M，Wang M，et al.International comparisons of prevalence，awareness，and treatment of pruritus in people on hemodialysis ［J］.Clin J Am Soc Nephrol，2017，12（12）： 2000.
3	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，2021，3（1）： 42-53.e1.
4	赵学谦，刘宗瑞.维持性血液透析患者治疗慢性肾脏病相关性瘙痒症的研究进展［J］.中国中西医结合肾病杂志，2024，25（6）： 563-564.
5	龚俊峰，张燕，罗琰琨.终末期肾脏病相关性皮肤瘙痒发病机制的研究进展［J］.重庆医学，2024，53（21）： 3323-3328.
6	Elias PM.Optimizing emollient therapy for skin barrier repair in atopic dermatitis ［J］.Ann Allergy Asthma Immunol，2022，128（5）：505-511.
7	Rawlings AV，Matts PJ.Stratum corneum moisturization at the molecular level：An update in relation to the dry skin cycle ［J］.J Invest Dermatol，2005，124（6）： 1099-1110.
8	Wala-Zielinska K，Swierczynska-Mroz K，Krajewski PK，et al.Endogenous opioid imbalance as a potential factor involved in the pathogenesis of chronic kidney disease-associated pruritus in dialysis patients ［J］.J Clin Med，2023，12（7）： 2474.
9	Ko MJ，Peng YS，Wu HY.Uremic pruritus： pathophysiology，clinical presentation，and treatments ［J］.Kidney Res Clin Pract，2023，42（1）：39-52.
10	Agarwal P，Garg V，Karagaiah P，et al.Chronic kidney diseaseassociated pruritus ［J］.Toxins，2021，13（8）： 527.
11	潘明明，刘必成.慢性肾脏病相关性瘙痒的发病机制及治疗进展［J］.中华肾脏病杂志，2024，40（10）： 846-850.
12	Mahmoud O，Oladipo O，Mahmoud RH，et al.Itch：From the skin to the brain-peripheral and central neural sensitization in chronic itch ［J］.Front Mol Neurosci，2023，16： 1272230.
13	Wala-Zielińska K，Świerczyńska-Mróz K，Krajewski PK，et al.Elevated level of serum neurotrophin-4，but not of brain-derived neurotrophic factor，in patients with chronic kidney disease-associated pruritus ［J］.J Clin Med，2022，11（21）： 6292.
14	Ruppenstein A，Limberg MM，Loser K，et al.Involvement of neuroimmune interactions in prurtus with special focus on receptor expressions ［J］.Front Med （Lausanne），2021，8： 627985.
15	Agelopoulos K，Pereira MP，Wiegmann H，et al.Cutaneous neuroimmune crosstalk in pruritus ［J］.Trends Mol Med，2022，28（6）：452-462.
16	Nattkemper LA，Kim BS，Yap QV，et al.Increased systemic levels of centrally acting B-type natriuretic peptide are associated with chronic itch of different types ［J］.J Invest Dermatol，2024，144（10）： 2267-2272.
17	Brennan F.The pathogenesis of CKD-associated pruritus：A theoretical model and relevance for treatment ［J］.Kidney360，2024，5（11）：1727-1738.
18	Makar M，Smyth B，Brennan F.Chronic kidney disease-associated pruritus：A review ［J］.Kidney Blood Press Res，2021，46（6）： 659-669.
19	Molina P，Ojeda R，Blanco A，et al.Etiopathogenesis of chronic kidney disease-associated pruritus： putting the pieces of the puzzle together ［J］.Nefrología（English Edition），2023，43（1）： 48-62.
20	Wu Q，Zhang H，Ding JR，et al.UPLC-QTOF MS-based serum metabolomic profiling analysis reveals the molecular perturbations underlying uremic pruritus ［J］.Biomed Res Int，2018，2018（1）：4351674.
21	Yang Y，Sun Y，Zhu C，et al.Allantoin induces pruritus by activating MrgprD in chronic kidney disease ［J］.J Cell Physiol，2023，238（4）：813-828.
22	Weng CH，Hu CC，Yen TH，et al.Assessing cross-sectional association of uremic pruritus with serum heavy metal levels：A single-center study［J］.Diagnostics（Basel），2023，13（23）： 3565.
23	Chuang PH，Tsai KF，Wang IK，et al.Blood aluminum levels in patients with hemodialysis and peritoneal dialysis ［J］.Int J Environ Res Public Health，2022，19（7）： 3885.
24	鲍敏锐，刘云，许世林，等.维持性血液透析患者全血微量元素与慢性肾脏病相关性瘙痒症程度的关联分析［J］.临床肾脏病杂志，2021，21（8）： 617-623.
25	Chang PC，Liao IC.Hydration，barrier of skin and uremic pruritus in patients undergoing hemodialysis：A pilot investigation ［J］.Nephrol Ther，2022，18（6）： 498-505.
26	Szepietowski JC，Kemeny L，Mettang T，et al.Long-term efficacy and tolerability of an emollient containing glycerol and paraffin for moderate-to-severe uremic xerosis：A randomized phase 3 study ［J］.Dermatol Ther （Heidelb），2024，14（11）： 3033-3046.
27	Verma V，Lamture Y，Ankar R.Management of uremic xerosis and chronic kidney disease（CKD）-associated pruritus（CKD-ap）with topical preparations：A systematic review and implications in the Indian context ［J］.Cureus，15（7）： e42587.
28	Anumas S，Kuropakornpong P，Chakkavittumrong P，et al.Cannabiscontaining cream for CKD-associated pruritus： A double-blind，placebo controlled trial ［J］.Kidney Med，2024，6（10）： 100894.
29	Widyastuti，Yahya YF，Nugroho SA，et al.Efficacy of calcipotriol 0.005% ointment for uremic xerosis with pruritus in chronic kidney diseases undergoing hemodialysis patients： Randomized double blind clinical trial ［J］.Biosci Med J Biomed Transl Res，2021，5（6）： 531-539.
30	Agarwal A，Das A，Hassanandani T，et al.Topical pramoxine in chronic pruritus：Where do we stand？［J］.Indian J Dermatol，2021，66（5）： 576.
31	Elsayed MM，Elgohary IE，Abdelhamid HHS，et al.The effectiveness of sertraline in alleviating uremic pruritus in hemodialysis patients： A randomized clinical trial ［J］.BMC Nephrol，2023，24（1）： 155.
32	Evoh OV，Chatterjee T，O'Mahony S，et al.Mirtazapine：A one-drug intervention for the physical and psychological symptoms of end-stage renal disease（ESRD）［J］.Cureus，2024，16（10）： e71439.
33	Xu W，Dong H，Ran H，et al.Efficacy and safety of pregabalin and gabapentin for pruritus：A systematic review and meta-analysis ［J］.J Pain Symptom Manage，2025，69（1）： 65-81.
34	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.
35	Kim BS，Inan S，Ständer S，et al.Role of kappa-opioid and muopioid receptors in pruritus：Peripheral and central itch circuits ［J］.Exp Dermatol，2022，31（12）： 1900-1907.
36	Di Giovanni M，Piccinni CP，Strazza C，et al.Difelikefalin： A new solution against itching in CKD-aP patients ［J］.Nephrol Dial Transplant，2024，39： I1470-I1471.
37	Lengton R，van der Willik EM，de Rooij ENM，et al.Effect of residual kidney function and dialysis adequacy on chronic pruritus in dialysis patients ［J］.Nephrol Dial Transplant，2023，38（6）： 1508-1518.
38	Marcello M，Marturano D，Ronco C，et al.The role of blood purification therapies in the treatment of chronic kidney diseaseassociated pruritus： A systematic review ［J］.Clin Kidney J，2024，17（9）： sfae266.
39	Ta k a h a s h i N，M a n o J，U c h i d a K，e t a l.E ff i c a c y o f polymethylmethacrylate membrane hemodiafilter filtryzer® PMFTM-21A in improving pruritus in hemodialysis patients： A prospective interventional study ［J］.Ren Replace Ther，2023，9（1）： 39.
40	Lin YL，Wang CL，Liu KL，et al.Omega-3 fatty acids improve chronic kidney disease-associated pruritus and inflammation ［J］.Medicina（Kaunas），2022，58（6）： 796.
41	Lin YL，Wang CL，Chiang TI.Eicosapentaenoic acid supplementation alleviates pruritus，enhances skin moisture，and mitigates depression in maintenance hemodialysis patients ［J］.Front Nephrol，2024，4：1365809.
42	Shabi I，Aboudar Z，Sidki M，et al.Effectiveness of narrowband ultraviolet light in chronic kidney disease-associated pruritus ［J］.Cureus，2024，16（1）： e53340.
43	Kee YK，J eon HJ，Oh J，et al.Vitamin D and narrowband ultraviolet B phototherapy for chronic kidney disease-associated pruritus ［J］.Kidney Res Clin Pract，2024，43（2）： 177-185.
44	应金希，张喜奎，朱为坤，等.张喜奎六经辨治慢性肾病相关性瘙痒经验［J］.国医论坛，2024，39（6）： 58-60.
45	郭凯琴，肖振卫.中西医治疗慢性肾脏病皮肤瘙痒的研究进展［J］.中医临床研究，2021，13（30）： 71-74.

[1]	Yufan Meng, Yongzheng Li, Zhiyao Fan, Hanxiang Zhan. Mechanism and research progress in intratumoral microbiota in the pathogenesis and progression of pancreatic cancer [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(04): 577-582.
[2]	Yingjie Duan, Junxia Du, Xiaonan Ding, Qinqin Ren, Fei Chen, Chenwen Song, Mingwei Tian, Dong Zhang, Hanyu Zhu. Advances in pathogenesis and prevention and treatment of heat stress-induced kidney injury [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2025, 14(02): 97-103.
[3]	Jing Zhao, Jiaxin Zhang, Yan Gao, Xisheng Xie. Progress of research on minimal change disease in its pathogenesis and treatment [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2024, 13(04): 207-212.
[4]	Ding Sun, Bin Wang, Xiangmei Chen, Yizhi Chen. Progress in the study of heat stress nephropathy [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2024, 13(03): 170-176.
[5]	Lili Chen, Xiaoyu Chen, Qi Dai, Shuangqing Wu, Qingdong Fu. Research advances in the pathogenesis of meibomian gland dysfunction [J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2025, 15(02): 124-128.
[6]	Hongyan Jia, Dan Wang, Ranran Zhang, Qian Ma, Yonghong Jiao. Genetic analysis on the pathogenesis of Möbius syndrome based on whole exome sequencing [J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2024, 14(03): 146-154.
[7]	Yanan An, Duanran Wang, Tiantian Guo, Xirun Wu. Research progress of Helicobacter pylori negative gastric mucosa-associated lymphoid tissue lymphoma [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2024, 14(03): 268-274.
[8]	Qi Liu, Shoukai Wang, Shuai Wang, Yuqing Su, Zhuang Ma, Haijun Chen, Pilei Si. Advances in research of intratumoral microbiome in breast cancer [J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(09): 841-845.
[9]	Ruonan Li, Jin Song, Yuzhong Wang. Progress on the pathogenesis and diagnosis and treatment of postherpetic neuralgia [J]. Chinese Journal of Diagnostics(Electronic Edition), 2024, 12(03): 199-205.
[10]	Qiuling Zhao, Hongping Li, Hao Wen, Weiwei Zhou, Yu Luo, Zhaohui He. Research progress of upper gastrointestinal bleeding in chronic kidney disease [J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2025, 12(01): 54-57.
[11]	Guangning Wang, Yujie Li, Kunfan Gao, Huisong Liu. Research progress on the role of short-chain fatty acids in the pathogenesis of sarcopenia [J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2024, 11(04): 31-37.
[12]	Kehan Wang, Tao Xu, Quanhong Zhou. Research progress on perioperative delirium and stress [J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2024, 11(03): 45-49.
[13]	Yuanxin Lu, Lilin Gong, Menghua Zeng. Research progress in the relationship between obesity and non-alcoholic fatty liver disease [J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2024, 10(02): 113-119.
[14]	Hua Huang, Zhijian Liang. Research advances on malignancy related hemorrhagic stroke [J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2024, 18(06): 611-615.
[15]	Yue Yu, Yuan Wang, Muhui Sang, Qin Shi. Analysis of vertigo pathogenesis syndrome element distribution using a vertigo syndrome differentiation scale [J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2024, 18(05): 454-458.

Please choose a citation manager

Content to export