Itchy Skin And Kidney Disease

Itching (also known as pruritus) is a common problem for those with kidney disease. It can be a distressing and often overlooked condition that affects 40% of patients with end stage CKD. Pruritus can disrupt your quality of life. “ Extremely itchy skin is a common symptom of advanced kidney disease. The itch can range from irritating to life-disrupting. Your skin may itch all (or most of) the time. Some people have itches on one area of their skin. The itch can also spread across most of your body.”

Toxins and waste can build up in the kidneys when they are damaged. Inflammation can also be caused by kidney disease. These factors contribute to the level of severity of itching. In the early stages of CKD, you may not notice any early warning signs. But as it progresses, your skin may show some of the following:

• Extremely dry skin. Can be caused by dialysis and high levels of phosphorus in the blood.
• Color changes to your skin. Caused by toxins build-up. Skin can look pale, gray or yellowish. Bumps and deep lines can also appear.
• Nail changes. Pale nails or a white color on the upper part of the nail with a reddish-brown color below.
• Rash. “One rash that occurs in people who have end-stage kidney disease causes small, dome-shaped, and extremely itchy bumps. As these bumps clear, new ones can form. Sometimes, the small bumps join together to form rough, raised patches.”
• Blisters. Can appear on hands, face or feet.

Itching is the most common skin condition with CKD. The severity can vary over time from barely noticeable to constant restlessness. It can occur at any time during dialysis (before, during or after). It is important to work in tandem with your doctor to alleviate as many side effects as possible. These are some of the medications available to relieve any pruritus:

• Over-the-counter medications such as Claritin (an antihistamine-loratadine) can help the itching without causing any drowsiness.
• An injection of difelikefalin (IV KORSUVA) is available to be administered 3 times a week after each dialysis visit.
• Gabapentin and pregabalin both appear to relieve itching.
• Nalfurafine has been shown to slightly relieve itching.
• Tips or related treatment options from a dermatologist may help.
• UVB phototherapy can be used for severe pruritus that does not respond to any other treatment.

Pruritus commonly occurs on the arms, back, head or belly. “Pruritus is different from the itchiness of, say, a bug bite or a scratchy sweater. It creates a prickly feeling under the skin that does not go away from scratching. This itchiness can be extremely annoying and unpleasant. It often gets worse at night. Heat and stress have been shown to make itching worse.”

• If you are on dialysis, ensure you are on the right dosage amount.
• Follow a kidney-friendly diet.
• Try to avoid scratching your skin, which only makes itching worse.
• When bathing, use lukewarm or cool water. Do not take hot showers, which can make dry, itchy skin worse.
• Try topical treatments such as menthol creams and capsaicin lotion. These can help calm and soothe the skin.