衛教資訊
Pruritus in Dialysis Patients 如何改善透析病人搔癢症
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Pruritus in Dialysis Patients 如何改善透析病人搔癢症
2024/1/2
Itchiness has been the most common and frustrating problem in uremic patients. About 60% of dialysis patients have itching problem. Current research shows that the causes of itch are numerous and complicated.
Causes
- Hyperparathyroidism.
- High levels of phosphorus and calcium in the blood; dry skin.
- Dialysis inadequacy related accumulation of uremic toxin.
- Anemia, iron deficiency.
- Sweat gland hypofunction.
- Side effects of medications and allergies, such as heparin, disinfecting agents and tape allergies.
- Allergy to artificial kidney disinfectant or material.
Treatment
- Adequate dialysis, increased blood flow, dialysis duration, and artificial kidney size.
- Low-phosphorus diets and phosphor-binding drugs are used to reduce blood phosphorus to improve itching, while active vitamin D can low down the levels of parathyroid hormone.
- The usage of erythropoietin has been shown to improve anemia, or itching.
- Don't take too hot showers; cotton clothing is recommended; apply moisturizer to keep skin moist.
- Improve itchy skin by taking or applying antipruritic drugs as prescribed by your doctor, or going to the dermatology clinic.
- Use a cold towel to wipe and cool the skin or take low-temperature dialysis.
- Change the type of heparin and review the suitability of artificial kidney or disinfectant (except peritoneal dialysis). In a few dialysis cases, itchy skin may be associated with allergies to the anticoagulant heparin, artificial kidney or disinfectant.
- 王裕方、廖建富、陳明新、陳瑋毅、戴有志、呂秉勳(2022).尿毒搔癢症治療之系統性回顧.台灣醫學,26(3),271-286。https://doi.org/10.6320/FJM.202205_26(3).0002
- Simonsen, E., Komenda, P., Lerner, B., Askin, N., Bohm, C., Shaw, J., Tangri, N., & Rigatto, C. (2017). Treatment of Uremic Pruritus: A Systematic Review. American journal of kidney diseases: the official journal of the National Kidney Foundation, 70(5), 638–655. https://doi.org/10.1053/j.ajkd.2017.05.018
製作單位:內科部腎臟系 編碼:HE-10138-E
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電話:(04) 22052121 分機 13255、11669、11760
中國醫藥大學附設醫院暨體系院所