مقايسه اثرات درماني گاباپنتين و آنتي هيستامين ها در درمان خارش اورميك و اختلالات سايكولوژيك ناشي از آن

COMPARISON OF GABAPENTIN AND ANTIHISTAMINS IN TREATMENT OF UREMIC PRURITUS AND ITS PSYCHOLOGICAL PROBLEMS

Background & Aims: Uremic pruritus is commonly experienced by patients suffering from advanced chronic renal failure who already are on renal replacement therapy. Gabapentin may be effective in treatment of uremic pruritus. This study aims at comparing gabapentin and antihistamine in treatment of uremic pruritus and its psychogenic problems. Methods & Materials: In a double-blind randomized clinical trial, 40 patients with uremic pruritus were randomized in two 20-patient groups in Tabriz Sina Hospital during a 12-month period. Both groups were matched for laboratory serum findings including Ca, P, PTH and Hb. One group received gabapentin (group G) and the other group received hydroxyzine (group A) for 4 weeks. Visual analogue scale (VAS) was used for determining the severity of pruritus at baseline and after intervention. HRQOL questionnaire was used for determining the quality of life. Results: There were 11 males and 9 females with the mean age of 46.2+12.4 years in group G and 9 females and 11 males, with a mean age of 45.6+12.4 years in group A (p=0.880). Decrease of pruritus severity was more significant in group G. All domains of quality of life were significantly improved better in patients receiving gabapentin compared with group A. Pruritus remained in 10% of patients in group G and in 80% of patients in group A (p<0.001). Complications were documented in 35% of patients in group G vs. 50% in group A (p=0.337). Conclusion: Gabapentin is more effective than antihistamine in treating uremic pruritus and its psychogenic problems with no significant side effects. Keywords: Gabapentin, Antihistamine, Uremic Pruritus