By Fran Kittell, RD
Does your skin itch? If so, you are not alone. Many patients with kidney disease have itchy skin, also call pruritis (pronounced proo-RI-tus). Some patients experience itching continuously; others have itching only for a few minutes each day. Sometimes, the itching is worse at night. Many patients say that the itching is worse on their back, but others say they experience itching on their arms, head and stomach. Why is this problem so common and what can you do about it?
The cause of itching in dialysis patients is not well understood. The problem seems to be more common in men, in patients who have poorly controlled calcium and phosphorus in their blood and in patients who have dry skin. Itching might be worse during periods of rest, when the temperature is hot, when a person is sweating and when a person is feeling stressed. Itching can improve during physical activity, when the temperature is cooler and during showers. Some hemodialysis patients say that itching is made better by dialysis; others say that dialysis treatments make the itching worse. There are probably many reasons for itchy skin.
Unfortunately, there is no "magic bullet" therapy with guaranteed results, but here are some possibilities.
First, you should work hard to keep your blood phosphorus and calcium at the target set for you. In addition, you might wonder, "Is there a medication to put on the skin?: Yes, there are three options. The first are non-prescription skin moisturing products that will help relieve dry skin and hopefully reduce itching. The second type of skin product is called capsaicin, found in many creams and lotions. Seek the advice of your pharmacist to purchase this product. You don't need a prescription. The third possibility is a steroid cream. This is something you should discuss with your nurse or doctor.
For itchiness that does not improve, there are other possibilities to discuss with your treatment team. For example, some patients respond to certain prescription medicines, including antihistamines, given by mouth. For other patients, it may be a good idea to involve a skin doctor who can provide treatment by exposing your skin to certain kinds of light.
If you experience itchy skin, discuss it with your nurse or doctor. There are several treatment options that may work. Anticipate a trial-and-error approach to find the best therapy for you.
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