Pruritus Treatment Algorithm for Hemodialysis Patients Non-PharmacoIogicaI Measures • Use gentle soap e.g. Dove • Apply soap only to axillae and groin/perineum (except if other areas such as arms or legs are visibly dirty) • Avoid excessive bathing or bathing with hot water - use only lukewarm water • Eliminate wool or irritating clothing • Keep finger nails trimmed • For dry skin, apply moisturizing cream (NOT lotion) BID and after bathing, e.g. glaxal base. Uremoli cream. Nivea' Cream. Creamy Vaseline Generalized Itchiness Oral antihistamine • Hydroxyzine10 mg PO TID PRN; titrate by 10-25 mg weekly to a maximum of 25 mg PO QID as tolerated • Diphenhydramine 25 mg PO BID-TID PRN. titrate by 25 mg weekly to maximum of 25 mg PO QID as tolerated Gabapentin 100 mg PO post HD (titrate by 100 mg weekly up to a maximum 300 mg PO HS as tolerated) #Pruritus #Treatment #Algorithm #Hemodialysis #Uremic #Uremia #Management #Nephrology #CKD
