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Abstract Chronic itch is defined as itch lasting more than 6 weeks. The prevalence of chronic pruritus in the general population has been reported to range from 8.4 to 13.9 %. Chronic Pruritus may involve the entire skin (generalized pruritus) or only particular areas, such as the scalp, upper back, arms, or groin (localized pruritus). Pruritus is one of the most common complaints associated with ESRD (End stage renal disease). Pruritus is present in anywhere from 40% to 90% of patients with ESRD, which reflects its subjective nature. Uremic pruritus (UP) is a common and disturbing problem in hemodialysis patients. Although its pathogenesis is not completely understood, it is thought to be multifactorial. Many hypotheses have been proposed regarding the development of UP. Recent hypotheses suggest that changes in the immune and opioid systems are to blame for UP. There are several recommended non pharmacologic and pharmacologic treatments available, such as gentle soaps and moisturizers, topical ointments and gabapentin. Substance P (SP) was the first identified mammalian neuropeptide, which was discovered in 1931 by Von Euler and Gaddum as a vasodilator substance in crude tissue extracts from equine brain and intestine. The acid alcohol extracted powder was at the time referred to as SP.Summary 74 When skin is stressed, SP is released from sensory nerves present in the upper dermal nerve plexus; these sensory nerves also innervate the epidermis. The released SP initiates skin inflammation via induction of vasodilation, plasma extravasation, and accumulation of immune factors, as well as uncomfortable skin sensations such as numbness, itching, sensitivity, and tingling. Very few studies have been published on the role of neuropeptides in chronic renal disease. Substance P, one of the neuropeptides, might be one of the main mediators of uremic pruritus. Histamine, which is released from mast cells in response to substance P, has been implicated in UP. The aim of this study is to evaluate the relation between serum Substance P level and Pruritus in renal patients. The current study was conducted according to sample size calculation on 44 renal pruritus patients & 30 sex and age matched healthy individuals as a control group and were selected by random sample. The studied subjects were collected from the inpatients at Menoufia University Hospitals. All patients were subjected to full history taking including (age, frequency of itching, time of itching and duration of chronic kidney disease). The results of our study revealed that there were statistically significant difference between patients and control group regarding to serum substance p level and serum C-reactive protein level. In this study there was no statistically significant difference between patients and control group regarding age and sex. Also, our study revealed that renal pruritus worse duringSummary 75 nighttime than during daytime and that the duration of chronic kidney disease correlated positively with the frequency of itching. |