Sertraline can reduce uremic pruritus in hemodialysis patient: A double blind randomized clinical trial from Southern Iran

Abstract

Introduction: Uremic pruritus is an undesirable complication of end stage renal disease (ESRD). In spite of introduction of many treatments for this complication, it has no certain cure. The aim of this study was to assess sertraline effect on uremic pruritus.

Methods: In the present clinical trial study, we randomly divided our patients into two groups; trial group that received sertraline and control group that consumed placebo. We measured the severity of pruritus by two scoring systems (visual analogue scale and DUO) at the beginning and during the study with a-2-week interval. Data were analyzed by SPSS 18.0 and a P value < 0.050 considered as significant.

Findings: The mean age of our patients was 44.1 ± 16.1 years. Pruritus intensity significantly decreased in both groups (P < 0.001) and both scoring systems. Although the amount of decrease in trial group was significantly more than control group (P < 0.001). We found a direct relation between blood urea nitrogen and phosphorus and the degree of itching in VAS system (P < 0.009). There was a reverse significant relation between itching and calcium in both scoring systems (P < 0.012). Also pruritus intensity was directly correlated with C-reactive protein in both scoring systems (P < 0.05).

Discussion: Depends on present study and previous ones, inflammation appears to play a significant role in uremic itching. Sertraline is an effective drug in reducing this complaint possibly due to its effect on reducing inflammatory cytokines. In addition there is no need to adjust sertraline dosage in patients with ESRD. Sertraline might be a treatment for patients with ESRD who do not respond to other routine drugs.

Keywords: Hemodialysis; SSRI; sertraline; uremic pruritus.