Relationship between Pruritus and Eosinophilia in Patients on Hemodialysis

Kang, Kwang Young; You, Min Young; Lee, Jun Sang; Ihm, Chull Wan; Moon, Chi Young; Park, Sung Kwang

Abstract

BACKGROUND: Pruritus is one of the most common complaints of patients with chronic renal failure undergoing hemodialysis. But its etiology is not clear, and there is no universally effective treatment. Recently we have experienced eosinophilia in hemodialysis patients suffering from pruritus.
OBJECTIVE
The purpose of the this study was to evaluate the relationship between pruritus and eosinophilia in patients on hemodialysis.
METHODS
We examined degree of pruritus and eosinophilia in 65 patients with end stage renal disease who were on hemodialysis from September 1996 to August 1997 in artificial kidney center of Chonbuk National University Hospital. The study was conducted by means of personal interview, physical examination, and review of medical records. The degree of pruritus was measured by scores from minimal 0 point to maximal 48 points and more than 5% or 500/mm3 eosinophils in peripheral blood was regarded as eosinophilia.
RESULTS
1)Incidence of each cutaneous symptoms were pruritus(61.5%), xerosis(35.4%), hyperpigmentation (30.8%), easy bruising(16.9%), nail change(12.3%), decreasing in sweating(10.8%), hypotrichosis(7.7%), and acne(4.6%). 2)Forty(61.5%) of 65 patients undergoing hemodialysis had pruritus, 32.3% in mild, 20% in moderate, and 9.2% in severe degree by pruritus score. 3)Nineteen(29.2%) of the 65 patients had eosinophilia:23.8%(5/21) of patients with mild pruritus, 30.7%(4/13) of patients with moderate pruritus, and 66.7%(4/6) of severe pruritus. It could be said that prevalence of eosinophilia was related to the severity of pruritus. 4)With repeated hemodialysis the severity of pruritus increased in 65%(26/40), decreased in 22.5% (9/40), did not change in 12.5%(5/40) of patients with pruritus. 5)Pruritus was not related to the serum calcium (Ca), inorganic phosphorus(PO4), CaxPO4 product, BUN, or creatinine. There was, however, significant correlations with the serum alkaline phohphatase.
CONCLUSION
There was a positive correlation bet- ween the prevalence of eosinophilia and severity of pruritus in patients on hemodialysis.