Serum bile acids and pruritus in hemodialysis patients

MAMIANETTI A*; TRIPODI VP; VESCINA MC; GARRIDO D; VIZIOLI NM; CARDUCCI CN; AGOST CARREÑO C

CLINICAL NEPHROLOGY

Dustri-Verlag

Lugar: Deisenhofen; Año: 2000 vol. 53 p. 194 - 198

0301-0430

Abstract. Background: Chronic renal failure (CRF) patients usually suffer from pruritus. The pathophysiology of pruritus is still incompletely understood. Subjects. mate­rials and methods: In this paper we deter­mined serum total bile acids (STBA) in hemodialysis patients with advanced CRF (ACRF) in order to obtain STBA concentra­tion in predialysis, to assess their probable relation among patients with' pruritus and in postdialysis using a poly sulfone membrane for dialysis. STBA were determined in 49 ACRF patients with chronic hemodialysis and values were compared to 20 control subjects. Hemodialysis patients were divided in two groups: with and without pruritus. In all these patients, month of renal replacement therapy, diabetic patients, dose of dialysis (Kt/V), viral markers, serum creatinine, serum glucose, aspartate and alanine aminotransferase, alka­line phosphatase, hematocrits and albumin were determined. The intensity of itching among pruritic patients was measured by a score system: mild (M), moderate (MP) and severe (S).Results: No significant differences were found in patients with and without pruri­tus in months 0f renal replacement therapy, duration of dialysis or dose of dialysis (KtN). STBA were determined in all ACRF patients in predialysis and they showed significant dif­ferences compared to controls (p < 0.05), however, no differences were observed in the results obtained when control subjects were compared to ACRF patients without pruritus. Also in predialysis, pruritic patients showed significant differences in STBA compared to patients without pruritus (p < 0.001). STBA concentration showed a significant decrease in postdialysis using a polysulfone membrane in ACRF patients with and without pruritus. Finally, correlation with STBA and itch score of pruritus was significant (p < 0.02).Conc1u­sion:Hemodialysis patients with ACRF and pruritus showed an increase of STBA in predialysis and a decrease in postdialysis.