Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Repeated exposure to mid-range ultraviolet light (UVB) can dramatically relieve the pruritus associated with uremia. The efficacy of UVB phototherapy in uremic pruritus has been established in a controlled trial; experience with 38 patients suggests that 80 to 90% of those receiving 6 to 8 exposures respond favorably within the treatment period (2 to 5 weeks). Treatment frequency appears not to influence the remission rate, although patients on more intensive schedules experience relief sooner than those treated once weekly. Remissions are long-lasting in many patients, sometimes longer than 2 years. Patients with recurrent pruritus respond to phototherapy at least as well as previously untreated patients and tend to improve more rapidly. UVB phototherapy appears to exert its beneficial effect systemically rather than locally, but its mechanism of action is otherwise unknown.
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PMID:Ultraviolet phototherapy of uremic pruritus. 51 36

The authors experimented Aloglutamol (an organic salt of aluminium) in uremic patients on dialysis to detect its phosphate-binding properties and study its use in the treatment of uremic osteodystropy. They report good results: predialysis Ca increased; serum PO4 and alcaline phosphatase levels decreased; Ca X PO4 was normalized; itch, muscular weakness and constipation decreased; no side-effects appeared, and the drug has a good taste. Therefore it is considered to be most useful in the treatment of hyperphosphatemia in uremia.
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PMID:[Use of Aloglutamol in uremic patients on dialysis (author's transl]. 70 77

Patients with uremia frequently have generalized pruritus that is usually related to a disturbance of calcium and phosphorus metabolism. This report describes three patients with uremia who had prurigo nodularis due to localized scratching and rubbing. The diagnosis of uremia in one case was made when the patient was hospitalized for evaluation of skin lesions.
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PMID:Prurigo nodularis and uremia. 111 44

Treatment with rHuEpo can eliminate many symptoms that had been attributed to uremia. Repetitive punctures in children undergoing three times weekly subcutaneous (SC) rHuEpo can result in noncompliance with the therapeutic regimen. The aim of this study was to evaluate the efficacy of once weekly SC injection of rHuEpo in children with end-stage renal disease (ESRD) on CAPD. Six children (5 males, 1 female, mean-age: 6.0 years, range: 0.5 to 15.8 years) with ESRD on CAPD were treated with a regimen of rHuEpo 150 U/Kg/week SC for 12 weeks. All patients received oral iron supplementation. All children had improved appetite and well-being. The adolescents showed an increased ability to engage in regular activities. The hematocrit increased from 20.3 +/- 1.2% to 31.7 +/- 3.8% in 12 weeks. The mean weekly increase in hematocrit was 0.95 +/- 0.34%. There was no significant differences in iron indice prior to and during rHuEPO treatment. Side effects related to rHuEpo included transient pain at the site of injection in all, pruritus at the site of injection in 1 child, hyperphosphatemia in 1 infant, iron relative deficiency in 2 children and an asymptomatic increase in blood pressure in 1 hypertensive child. None of the 5 normotensive patients developed hypertension. We concluded that once weekly 150U/kg SC rHuEpo is effective in correcting anemia in children on CAPD. This regimen results in few side effects, decreases the cost of treatment and produces less distress to the patients by avoiding repetitive injections.
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PMID:Once weekly subcutaneous administration of recombinant erythropoietin in children treated with CAPD. 136 43

A role for histamine in the pathogenesis of uremic pruritus was investigated in maintenance hemodialysis patients. Venous plasma histamine levels, as determined by radioenzymatic assay, were significantly higher (p less than 0.05) in hemodialysis patients with pruritus (368 +/- 103 pg/ml [mean +/- SEM], n = 6) than in those without pruritus (146 +/- 22 pg/ml, n = 5) and in normal controls (142 +/- 16, n = 5). Arteriovenous fistula histamine levels (202 +/- 52 pg/ml, n = 6) were significantly lower (p less than 0.05) than simultaneously drawn venous samples. Markedly elevated histamine-degrading enzyme (histaminase) activities were found in both hemodialysis patients with (2.95 +/- 0.18 pg histamine degraded/minute) and without (2.44 +/- 0.28) pruritus, but was undetectable in normal controls. Histaminase activities did not significantly differ in simultaneously drawn venous and fistula samples. With hemodialysis, histaminase activities fell significantly (p less than 0.01), whereas plasma histamine did not change. We further examined the effects of ketotifen, a putative mast cell stabilizer, on severe uremic pruritus. Five of five patients had significant (p less than 0.01) reductions in pruritus, as judged on a six-point pruritus index, after 8 weeks of drug (x = 2.3), as compared to conventional therapy (x = 5.9). Despite these improvements, no significant differences were noted in pre- versus post-drug plasma histamine levels, histaminase activities, or the histamine content per gram of skin biopsy specimen. These data support prior hypotheses that mast cell activation contributes to the pruritus of uremia.
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PMID:Elevated plasma histamine in chronic uremia. Effects of ketotifen on pruritus. 181 35

Hemodialysis can remove only substances that are highly diffusable, non protein bound and with small and middle-molecular weights. The combination of Hemodialysis-Hemoperfusion (HD-HF) takes advantage of both techniques. Uremic patient could reduce the number of weekly dialysis sessions. Fourteen uremic patients were submitted twice a week to a combined HD-HP treatment for 16 months. Polymethacrylate coated charcoal was inserted in the dialysis circuit before the dialyzer. The treatment resulted in improvement of: MNCV (30.5 + -6 to 38.7 + -5.6 m/sec.) subjective symptoms (disappearance of pruritus and insomnia) and hematological status (red blood cells 3.1 x 106 to 4.02 x 106; and hematocrits 28.3 to 36.1). Good control of serum biochemistries. Creatinine and urea clearances of 228 and 236 ml/min respectively. Significant removal of middle-molecules uremic toxins determinated by gel-filtration on Sephadex G15. In conclusion, we state that combined HD-HP improves the detoxication possibilities in chronic uremia.
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PMID:Our experience with combined hemodialysis-hemoperfusion treatment in chronic uremia. 344 35

In a study of 46 patients with nodular prurigo (NP), potential metabolic causes of pruritus, such as anaemia, hepatic dysfunction, uraemia and myxoedema, were present in 50%. Focal causes of pruritus were important in 37% and included insect bites, venous stasis, folliculitis and nummular eczema. Psycho-social disorders were recorded in over 50% of patients and were considered relevant in 33%. Clinical and histological appearances ranged from classical NP to chronic lichenified eczema. Neural hyperplasia was not a prominent feature.
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PMID:Nodular prurigo--a clinicopathological study of 46 patients. 406 79

Chronic intermittent hemodialysis may relieve some medical problems of terminal uremia (for example, azotemia, acidosis, hypertension, neuro-muscular disorders, bleeding, pericarditis) to such a degree that many patients are able to resume their normal activity. There remain, however, problems which are not readily changed by hemodialysis (anemia, peripheral neuropathy, pruritus, sexual impotence, renal osteodystrophy). These, together with medical problems possibly caused by hemodialysis (for example, osmotic disequilibrium, errors in dialysate composition, hepatitis, hemosiderosis, isoimmunization from blood transfusions, shunt problems and psychological problems of dependency upon the artificial kidney) represent a limitation of the present type of hemodialysis therapy.
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PMID:Some medical problems of chronic hemodialysis. 486 55

The selection of Norit RBX-1-activated carbon granules for blood detoxification by haemoadsorption is outlined. Synthetic polymer membranes have been coated on to this carbon by a specially developed process and perfusion devices prepared from these materials have been evaluated in animal models of acute poisoning and liver failure. Clinical application of carbon haemoadsorption has been explored in acute poisoning, liver failure and uraemia. The experience to date would suggest that carbon will have to be augmented by other adsorbent species before life support systems based principally on haemoadsorption become a reality especially in the treatment of uraemia and in liver failure. A secondary role as a temporary adjunct to dialysis has been established for carbon haemoperfusion in the treatment of uraemic pericarditis and is under further investigation in the treatment of pruritus, pigmentation and neuropathy.
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PMID:Reflections on the role of carbon haemoadsorption in therapeutic medicine. 704 98

Discrepancies have existed regarding the correlation between raised bile acid levels in cholestasis and the presence of pruritus. Nevertheless, the prevalent view is that bile acids have a direct etiologic role. To resolve the issue, we quantified separately all naturally-occurring bile acid species detectable in serum and skin, and on the skin surface of 13 patients with pruritus associated with cholestasis, 10 patients with cholestasis who did not have pruritus, three patients with uremia and generalized pruritus and in 10 controls. We were unable to find any correlations between the presence of pruritus and bile acid levels from the various sources. We did find great overlap in these same values with data from the group with cholestasis but without pruritus. As expected, the symptomatic (uremic) and asymptomatic control groups showed comparable levels. The results of the present study together with those of a similar recent study provide strong evidence against the hypothesis of a direct causative role for retained bile acids in pruritus associated with cholestasis.
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PMID:Pruritus in cholestasis: no direct causative role for bile acid retention. 723 69


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