Algorithm for the Treatment of Uremic Pruritus Nonpharmacologic Treatments: • Daily topical emollient • Avoidance of extremes of temperature Evidence-Based Off-Label Pharmacologic Treatments of Uremic Pruritus: • Gabapentin 100 mg after HD or every other day - Increase by 100 mg, up to max 300 mg QHS • Prebabalin 25 mg after HD or QOD • Increase by 25 mg up to max 75 mg daily Treatments with Limited Effcacy Data: • Topical capsaicin 0.025% + menthol 4% • Topical cromolyn sodium 4% • UV-B phototherapy • Evening primrose oil 1000 mg/d • Sertraline 50 mg/d • mu- opioid receptor antagonist/k-receptor agonists (nalbuphine 120 mg/d) • k-opioid receptor agonists (nalfurafine 2.5 mcg/d) #Uremic #Pruritus #uremia #itching #Algorithm #Treatment #management #nephrology
