Comparison of hemodiafiltration and hemodialysis in patients with uraemic pruritus

Abstract

Background: Chronic kidney disease (CKD)-associated pruritus is a common complicationin patients with end-stage renal disease. Objectives: To compare the capabilities of hemodialysis (HD) and ‏hemodiafiltration‏(HDF) in clearing toxins and their effects on pruritus inuremic patients. Patients and methods: The study included 40 adult subjects (18 years or older) who had maintenance dialysis for at least three months. Patients were divided into two groups: Group I: 20 patients underwent maintenance HDF (Intervention group), Group II: 20 patients underwent maintenance HD (Control group). Serum calcium levels, serum phosphorus levels, serum parathormone levels (PTH) and serum B2 microglobulin were assessed. The severity of pruritus measured by the visual analogue scale (VAS). Results: The prevalence of Uremic Pruritus in our study was 52.5% in all studied patients.We found a statistically significant difference (p-value < 0.05) between studied groups as regard Uremic Pruritis.The prevalence of UP was higher in HD group (70 %) in compare with HDF group (35 %). We found a Statistically significant difference (p-value < 0.05) between HDF group & HD group regard B2 mico-globulin &PTH. Levels of PTH and B2 microglobulin were significantly higher in HD group(175.2 ± 36.1pg/ml and 11.3 ± 2.1μg/ml, respectively) as compared with HDF group (207.9 ± 36.4pg/ml and 14.1 ± 4.04μg/ml, respectively). Conclusion: The prevalence and severity of Uremic Pruritus were significantlylower among HDF patients than HD patients. HDF can clear b2-MG and PTH and provide relief from pruritus efficiently more than HD.

Keywords

• hemodialysis; hemodiafiltration; uremic pruritus