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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The subject of itching associated with renal failure is discussed. Possible pathogenetic mechanisms and available therapeutic modalities are presented.
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PMID:Uremic pruritus: a review. 38 Sep 32

During the period 1971-1976, subtotal parathyroidectomy was performed on 34 patients with chronic renal failure, representing 8% of all uraemic patients treated on the Renal Ward. Preoperative treatment of renal failure was conservative therapy in 6, haemodialysis in 20 and renal transplantation in 8 patients. The operation was indicated by grave clinical symptoms (pruritus, bone pains and mental disturbances), gastric ulcer and radiological abnormalities (osteoporosis, fractures, subperiosteal resorption and metastatic calcifications). The serum immunoreactive parathyroid hormone was determined in 13 cases, and the value was elevated in all. The serum calcium level was elevated in 8 out of 34 cases. Less than 500 mg of parathyroid tissue was removed in 12 cases, between 500 and 6000 mg in 19 and over 6000 mg in 3. Nodular hyperplasia was present in 11 patients, diffuse hyperplasia in 23. Postoperatively marked falls in serum parathyroid hormone and serum calcium values were observed. The bone pains, pruritus and mental disturbances were alleviated, and the general condition was favourably influenced. The operation had a lesser and more retarded effect on the radiological changes. Complete recovery was only achieved with successful renal transplant. Parathyroidectomy often had a favourable effect on the grave symptoms and may, therefore, be considered in some cases of severe hyperparathyroidism secondary to chronic renal failure.
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PMID:Parathyroidectomy in chronic renal failure. 43 13

The authors studied the skin disorders in 50 hemodialyzed patients. Pruritus appears to be the main dermatological feature by the frequency of its occurrence and by its unpleasant and even intolerable effects. This sign is more frequent among long time dialyzed patients and seems to be due to 2 factors: high urea blood concentration and secondary hyperparathyroidism. Calcinosis cutis is less frequent than pruritus. It seems to have the same origin and can be considered in the more general picture of the metastatic calcinosis in patients with renal failure and secondary hyperparathyroidism. Hypermelanosis, exceptional in the chronic renal insufficiency patients before hemodialysis, is present in 41% of our group. It is more obvious in the long time dialyzed patients. The nail disorders are mostly the absence of lunula (30%), related to the anaemia, and the half and half nail (36%) that seems specific of the severe azotaemia. Skin dryness (30%) and ichthyosis (10%) can be related to the pruritus. Alopecia, drug reactions and prurigo seems to have a particular indidence. Two patients presented bullous eruptions localized in sunlight exposed areas of skin. The clinical, histological and immunological aspect was identical to that observed in the Porphyria Cutanea Tarda but all the porphyrin levels in the urine and faeces were normal.
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PMID:[Skin manifestations in patients with renal chronic renal failure on regular hemodyalysis]. 103 95

A 62-year-old woman presented with uveitis and abnormal chest X-ray (bilateral hilar adenopathy). Skin biopsy in 1983 had revealed non-caseating epithelioid cell granuloma consistent with sarcoidosis. Her serum biochemical investigations and exploratory laparoscopy suggested nodular liver cirrhosis, but biopsy was not performed. Both blood urea nitrogen (BUN) and serum creatinine values were within normal limits. She received prednisolone therapy of 15 mg daily initially, and later a maintenance dose of 5 mg daily. In 1985, she complained of skin itching and her laboratory data revealed severe renal insufficiency (BUN 97 mg/dl, serum creatinine 12.2 mg/dl) and hypercalcemia (corrected serum calcium level: 11.5 mg/dl). Prednisolone treatment (40 mg daily) resulted in a dramatic improvement of renal function as well as other clinical abnormalities due to sarcoidosis, without any significant changes in liver function. She died of cerebral infarction in 1989. Autopsy showed interstitial nephritis with tubular calcinosis and hyalinized glomeruli. It is postulated that hypercalcemia due to sarcoidosis contributed to the renal failure in this patient. This case suggests that renal damage due to sarcoidosis may be reversible with appropriate corticosteroid therapy.
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PMID:[An autopsy case of sarcoidosis associated with renal failure]. 140 82

Itching in nondialyzed uremic subjects and patients on dialysis remains incompletely explained and poorly treated. We evaluated our chronic hemo- and peritoneal dialysis patients for this symptom and synthetically reviewed previous reports on itching and renal failure. We found no biochemical correlates of itching but did find that itching was less with better dialysis as defined by urea kinetic modelling. We conclude that improved dialysis techniques will continue to reduce the prevalence of itching in end-stage renal disease patients.
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PMID:Dialysis efficacy and itching in renal failure. 143 34

The number of mast cells in the skin was evaluated in 25 patients with end-stage renal failure on different treatment modality (conservative, hemodialysis and peritoneal dialysis). According to the presence of pruritus, uremic patients were divided into two groups: group A, 13 patients with diffuse pruritus, and group B, 12 patients without pruritus. Controls were 6 age- and sex-matched healthy subjects. In comparison with patients without pruritus, patients with pruritus had mainly degranulated, diffusely spread and more numerous mast cells in the skin; significantly higher levels of plasma middle molecular weight substances, serum histamine and PTH and significantly lower serum iron levels. However, no differences were noted in observed parameters between groups on different treatment modalities. Favorable therapeutic effects in patients with pruritus were achieved either with iron supplementation in those with hypoferremia or with antihistamines, mast cell membrane stabilizers and high-permeability membranes.
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PMID:Uremic pruritus and skin mast cells. 152 40

Pruritus is an important sign of localized or systemic disease and sometimes may be the only symptom of potentially fatal illness. Localized causes of pruritus include stasis dermatitis, atopic dermatitis, contact dermatitis, neurodermatitis and scabies. Generalized pruritus may be caused by environmental factors such as low humidity, skin diseases such as urticaria, or internal diseases such as biliary obstruction, renal failure, hematologic malignancy or acquired immunodeficiency syndrome. Therapy for pruritus depends on identification and treatment of the underlying cause. If no specific etiology is found, therapy is palliative. Avoidance of frequent bathing may be helpful, especially when xerosis plays a role. Topical emollients or short-term therapy with low-potency steroids may also be effective. Oral antihistamines provide nonspecific relief for many patients with intractable pruritus.
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PMID:Pruritus. 159 16

Disseminated rash and pruritus are described in an 82-year-old woman with chronic renal failure following administration of oral vancomycin hydrochloride 125 mg q6h for the treatment of Clostridium difficile colitis. Renal function was estimated to be 0.27 mL/s based on a serum creatinine of 177 mumol/L. After eight days of therapy, she developed a slightly raised maculopapular rash on her legs and torso, which spread to her abdomen and arms with continued treatment. Vancomycin was discontinued and the patient was treated symptomatically. The rash cleared and did not recur. Rechallenge with vancomycin was not initiated. No other changes in medications or initiations of new medications occurred during the time of treatment with vancomycin. The patient denied any previous immunologically mediated reactions to medications. Maculopapular rash is rare secondary to vancomycin administration, particularly after oral administration. Although clinically significant serum concentrations can be obtained in patients treated with oral vancomycin who have concomitant C. difficile colitis and renal failure, there has not been a clear correlation between these concentrations and any reported adverse sequelae. This case supports the possible occurrence of a true allergic reaction secondary to low-dose oral vancomycin administration.
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PMID:Oral vancomycin-induced rash: case report and review of the literature. 184 8

A 50-year-old woman with primary biliary cirrhosis developed immune hemolytic anemia and renal failure while receiving rifampicin for the treatment of refractory pruritus. Serological studies revealed the presence of rifampicin-dependent antibodies of the IgM class that, when tested against a wide panel of erythrocytes, had anti-I specificity. Subsequently, rifampicin was withdrawn and prednisone treatment instituted, this resulting in a rapid resolution of the hemolysis, whereas hemodialysis was required for recovery of the renal function. A role is suggested for the anti-I specificity of the antibodies in the development of renal failure associated with rifampicin therapy.
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PMID:Immune hemolytic anemia and renal failure associated with rifampicin-dependent antibodies with anti-I specificity. 187 25

The skin is the most visible and easily accessible organ of the body. For an astute clinician, the skin may function as an important diagnostic window to diseases affecting internal organs. This is especially true for the renal system. Chronic renal failure, regardless of its cause, often produces xerosis, pruritus, sallow hyperpigmentation, and nail changes. Half-and-half nails occur frequently in patients with renal failure and are formed of a white proximal nail portion and a normal pink distal end. Uremic frost can occur on the skin in patients with severe renal failure of long duration. This white coating on the skin is caused by an increased concentration of urea in the sweat. However, long before failure is manifested clinically, specific dermatologic abnormalities can provide clues to the cause of renal disease. We review here the hereditary, metabolic, and vascular disorders that affect both the kidney and skin. The dermatologic manifestations are stressed as important guides to the diagnosis of renal disease.
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PMID:Cutaneous clues to renal disease. 207 Jun 44


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