Special Issue "Pathogenesis and Therapy of Chronic Kidney Disease-Associated Itch (Uremic Pruritus)"

A special issue of Toxins (ISSN 2072-6651). This special issue belongs to the section "Uremic Toxins".

Deadline for manuscript submissions: 31 January 2022.

Special Issue Editors

Prof. Dr. Katarzyna Kilis-Pstrusinska
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Guest Editor
Department of Paediatric Nephrology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland
Interests: chronic kidney disease; uremic toxins; chronic kidney disease-associated itch; psychosocial; health-related quality of life
Prof. Dr. Jacek C Szepietowski
E-Mail Website
Guest Editor
Department of Dermatology, Venereology and Allergology, Wroclaw Medcial Unieversity, ul. T. Chałubińskiego 1, 50-367 Wroclaw, Poland
Interests: systemic itch; uremic pruritus; itch in dermatoses; skin and psyche
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Special Issue Information

Dear Colleagues,

Chronic kidney disease (CKD) is a growing problem worldwide, with prevalence of advanced stages (three to five stages) in about 11% of the general population. CKD is associated with numerous complications, with cutaneous ones being considered common. CKD-associated itch, for years also called uremic pruritus, is defined as chronic itch in patients with CKD with advanced stages of renal damage. The diagnosis includes the exclusion of other possible causes. CKD-associated itch is regarded as one of the most bothersome symptoms in patients requiring dialysis treatment. Its prevalence is currently estimated at 40% among dialysis patients. Although described for the first time in 1932, CKD-associated itch is still an unsolved and important clinical challenge. As the pathogenesis is not completely clear, there is no one “gold” treatment available and registered. The pathogenesis of this type of itch is multifactorial, with several factors contributing to the development and/or exacerbation of this sensation. Recently, several studies have been conducted to understand the processes leading to chronic itch in uremic patients in more depth. This resulted in new hypotheses and new treatment targets (within the neural and immune system) for CKD-associated itch. Several new agents specifically aiming to relive CKD-associated itch (e.g., difelikefalin, nalbuphine) are under development. The aim of this Special Issue is to offer a platform, both for clinicians and basic researchers, to present and discuss novel issues in the pathogenesis and treatment of CKD-associated itch. We do hope that all published papers will significantly contribute to a better understanding of CKD-associated itch and will be of benefit for suffering patients in the future.

Prof. Dr. Katarzyna Kilis-Pstrusinska
Prof. Dr. Jacek Szepietowski
Guest Editors

Manuscript Submission Information

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Keywords

  • Chronic itch
  • Chronic kidney disease-associated itch
  • Etiology
  • Pathogenesis
  • Treatment options
  • Difelikefalin
  • Nalbuphine
  • Anti-interleukin agents.

Published Papers (2 papers)

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Review

Review
Chronic Kidney Disease-Associated Pruritus
Toxins 2021, 13(8), 527; https://0-doi-org.brum.beds.ac.uk/10.3390/toxins13080527 - 28 Jul 2021
Viewed by 836
Abstract
Pruritus is a distressing condition associated with end-stage renal disease (ESRD), advanced chronic kidney disease (CKD), as well as maintenance dialysis and adversely affects the quality of life (QOL) of these patients. It has been reported to range from 20% to as high [...] Read more.
Pruritus is a distressing condition associated with end-stage renal disease (ESRD), advanced chronic kidney disease (CKD), as well as maintenance dialysis and adversely affects the quality of life (QOL) of these patients. It has been reported to range from 20% to as high as 90%. The mechanism of CKD-associated pruritus (CKD-aP) has not been clearly identified, and many theories have been proposed to explain it. Many risk factors have been found to be associated with CKD-aP. The pruritus in CKD presents with diverse clinical features, and there are no set features to diagnose it.The patients with CKD-aP are mainly treated by nephrologists, primary care doctors, and dermatologists. Many treatments have been tried but nothing has been effective. The search of literature included peer-reviewed articles, including clinical trials and scientific reviews. Literature was identified through March 2021, and references of respective articles and only articles published in the English language were included. Full article
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Review
Chronic Kidney Disease-Associated Itch (CKD-aI) in Children—A Narrative Review
Toxins 2021, 13(7), 450; https://0-doi-org.brum.beds.ac.uk/10.3390/toxins13070450 - 29 Jun 2021
Viewed by 728
Abstract
Chronic kidney disease (CKD) is a condition of widespread epidemiology and serious consequences affecting all organs of the organism and associated with significant mortality. The knowledge on CKD is rapidly evolving, especially concerning adults. Recently, more data is also appearing regarding CKD in [...] Read more.
Chronic kidney disease (CKD) is a condition of widespread epidemiology and serious consequences affecting all organs of the organism and associated with significant mortality. The knowledge on CKD is rapidly evolving, especially concerning adults. Recently, more data is also appearing regarding CKD in children. Chronic itch (CI) is a common symptom appearing due to various underlying dermatological and systemic conditions. CI may also appear in association with CKD and is termed chronic kidney disease-associated itch (CKD-aI). CKD-aI is relatively well-described in the literature concerning adults, yet it also affects children. Unfortunately, the data on paediatric CKD-aI is particularly scarce. This narrative review aims to describe various aspects of CKD-aI with an emphasis on children, based on the available data in this population and the data extrapolated from adults. Its pathogenesis is described in details, focusing on the growing role of uraemic toxins (UTs), as well as immune dysfunction, altered opioid transmission, infectious agents, xerosis, neuropathy and dialysis-associated aspects. Moreover, epidemiological and clinical aspects are reviewed based on the few data on CKD-aI in children, whereas treatment recommendations are proposed as well, based on the literature on CKD-aI in adults and own experience in managing CI in children. Full article
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