Association Between Uremic Pruritus and Serum Level of Fibroblast Growth Factor 23 in Hemodialysis Patients in North of Iran: An Observational Study

Background: Chronic itch (CI) in hemodialysis (HD), also called uremic pruritus (UP), is a common, distressing, and unpleasant symptom. Fibroblast growth factor 23 (FGF23) is a bone-secreted phosphaturic factor. Several bone diseases can accompany kidney diseases. It is unclear whether the common disturbance of calcium/phosphate homeostasis can cause CI in chronic kidney disease. Objectives: This study investigated the association between FGF23 and UP among HD patients in northern Iran. Methods: Patients undergoing maintenance HD at four referral medical centers were recruited in this cross-sectional survey. The enzyme-linked immunosorbent assay was used to evaluate serum FGF23 levels. An interview questionnaire was used to analyze the various aspects of pruritus. Results: Of 237 subjects, 54.01% had UP. There was no difference in serum FGF23 levels between patients with and without UP (413.17 ± 416.97 vs. 410.81 ± 444.49, P = 0.85). Those with UP required dialysis for a longer period (P = 0.02). FGF23 was shown to be associated with parathyroid hormone in UP (P = 0.02, r = 0.41). Conclusions: There was no linear correlation between FGF23 and UP in this study.