Management of Pruritus in Patients with Chronic Kidney Disease Pruritus with no primary lesions - differential diagnosis: • Renal pruritus • Liver disease/cholestatic pruritus • Hematologic pruritus (Iron deficiency anemia, Polycythemia vera) Management of Dry Skin – General Measures 1. Bathing recommendations: • Fragrance-free sensitive skin bar soap (i.e. Dove sensitive skin® bar soap) • Limit use of soap to axillae and groin/perineum • Avoid excessive bathing or bathing with hot water 2. Avoid wearing rough clothing, such as wool, over itchy areas. 3. Use mild detergent for clothes/sheets and rinse well. 4. Keep fingernails short and clean. Try not to rub or scratch the itchy areas. 5. Keep your house cool and humid, especially in the winter. 6. Topical emollients: • Fragrance-free emollient* BID to TID and especially after bathing; OR • Baby oil BID to TID; OR • Menthol 0.25%/camphor 0.25% in emollient* BID to TID • For localized pruritus: • Consider Capsaicin 0.025% cream, apply sparingly BID-QID (onset of action 2-4 weeks) • Pramoxine 1% in emollient BID-TID PRN 7. Consider acupuncture • Malignancy (leukemia, Hodgkin and Non-Hodgkin lymphoma) • Endocrine pruritus (thyroid disease, uncontrolled diabetes) #Pruritus #Treatment #Algorithm #Hemodialysis #Uremic #Uremia #Management #Nephrology #CKD
