Highlight
– CKD-associated pruritus (CKD-aP) is highly prevalent in the dialysis population, affecting up to 85% of patients and often goes underrecognized and undertreated.
– Pathogenesis involves a complex interplay of uremic toxins, metabolic derangements, immune dysregulation, and altered opioid receptor signaling.
– Stepwise management includes optimizing dialysis, topical therapies, systemic agents (gabapentinoids, mast cell stabilizers), and targeted treatments such as opioid receptor modulators and IL-31 antagonists.
– Nemolizumab, an IL-31 receptor antagonist, demonstrates promising efficacy in refractory cases and may shape future therapeutic paradigms.
