Management of chronic kidney disease–associated pruritus

CKD-aP: chronic kidney disease–associated pruritus; CKD-MBD: chronic kidney disease mineral and bone disorder.

* Refer to UpToDate content on prescribing and assessing adequate hemodialysis and prescribing peritoneal dialysis for details.

¶ Refer to UpToDate content on management of secondary hyperparathyroidism in dialysis and nondialysis CKD, and management of hyperphosphatemia in adults with CKD. In some patients, optimal control of CKD-MBD parameters may occur after pruritus has improved with an anti-pruritic agent (eg, gabapentin or difelikefalin). In such patients, it is reasonable to discontinue the pharmacologic agent as a trial. If pruritus returns despite optimal treatment of CKD-MBD, the anti-pruritic agent may be resumed.

Δ Emollients generally should be continued along with other therapies, especially if xerosis (dry skin) is present on physical examination.

◊ Refer to UpToDate content on CKD-aP for details.