بررسي مقايسه اي نالتروكسان خوراكي با هيدروكسي زين در درمان خارش مبتلايان به نارسايي مزمن كليه تحت درمان با همودياليز- يك مطالعه راهنما

Evaluating the Efficacy of Oral Naltrexone in the Treatment of Uremic Pruritus as compared with Hydroxyzin—A pilot study

In spite of extensive investigation on its treatment, uremic pruritus has remained a common problem in patients suffering from advanced renal insufficiency. Among newly introduced treatments, Naltrexone, an opioid antagonist, seems to have different effects.The objective of this trial is to evaluate the efficacy of oral Naltrexone in the treatment of uremic pruritus in patients with chronic renal failure as compared with Hydroxyzine.20 patients undergoing dialysis at the dialysis center of Qaem and Emam Reza hospitals in Mashhad took part in the trial. The subjects received 50 mgs of Naltrexone per day for 2 weeks at both the beginning and during the treatment.Their pruritus was assessed at the beginning and at the end of each week using a questionnaire about their daily scratching activities, the distribution of pruritus in the body, and pruritus - related sleep disturbances. Then, having stopped the treatment for a week, we continued the same procedures for the second course with 35mg/day. During the trial, the serum level of Ca, P and PTH were determined. The itching rate dropped by more than 50 percent which was regarded as a positive response.14 patients of all participants completed the trial, 10 of whom showed a positive response to Naltrexone while 4 of them did not. 6 patients found Hydroxyzine to be effective whereas to 4 of them it was non-effective. Another 4 patients did not respond to Naltrexone. Hydroxyzine was not effective, either (P<0.05).In this trial, Naltrexone showed to be superior to Hydroxyzine for controlling itching in uremic patients.