Polymethylmethacrylate Efficacy in Reduction of Renal Itching in Hemodialysis Patients: Crossover Study and Role of Tumor Necrosis Factor-α
Article first published online: 20 DEC 2001
Volume 25, Issue 6, pages 441–447, June 2001
How to Cite
Kato, A., Takita, T., Furuhashi, M., Takahashi, T., Watanabe, T., Maruyama, Y. and Hishida, A. (2001), Polymethylmethacrylate Efficacy in Reduction of Renal Itching in Hemodialysis Patients: Crossover Study and Role of Tumor Necrosis Factor-α. Artificial Organs, 25: 441–447. doi: 10.1046/j.1525-1594.2001.025006441.x
- Issue published online: 20 DEC 2001
- Article first published online: 20 DEC 2001
- Received November 2000; revised January 2001.
- Soluble tumor necrosis factor receptors;
Abstract: Pruritus is one of the major unsolved problems for patients receiving regular hemodialysis. In this study, we conducted a 6 month prospective and crossover trial to investigate the effect of polymethylmethacrylate (PMMA) membrane for renal itching. We also examined the role of the tumor necrosis factor (TNF)-α system for pruritus in hemodialysis patients. We assessed the degree of skin itching and measured circulating levels of TNF-α and soluble TNF receptors (sTNFR-I, sTNFR-II) in 19 patients using hemodialysis, complicated by prolonged severe pruritus for 6 months. Serum sTNFR-I and II levels were significantly elevated in hemodialysis patients compared to normal subjects. Serum sTNFR-II levels were significantly and negatively correlated with serum albumin (r = −0.602, p = 0.007). A significant positive relationship was also found between sTNFR-I and erythropoietin dosage (r = 0.554, p = 0.016). However, no association was found between the degree of pruritus and circulating sTNFR-I and II values. Skin itching scale was significantly decreased from 2.7 ± 0.2 to 2.1 ± 0.3 following the use of PMMA membrane for 3 months (p < 0.05). In contrast, there was no change in itching scales during 3 months of conventional therapy (2.2 ± 0.3 versus 2.2 ± 0.3, p = NS). PMMA itself did not affect serum TNF-α and sTNFR values as well as conventional dialyzer membranes. These findings suggested that the PMMA dialyzer can improve renal itching not mediated through the modification of the TNF-α system.