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Uric Acid and Pruritus
Solutions for Peritoneal Dialysis Patients

Uric acid is a waste product produced when the body breaks down purines found in various foods and beverages. Under normal circumstances, uric acid is dissolved in the blood, filtered by the kidneys, and then excreted through the urine. However, in people with kidney problems, uric acid can build up in the blood and cause problems such as itching, especially in patients on peritoneal dialysis.

Peritoneal dialysis is a treatment for kidney failure that utilizes the lining of the abdomen, or peritoneum, as a natural filter to remove waste and excess fluid from the body. This type of dialysis is often chosen as a more flexible and convenient alternative to hemodialysis.

Causes of itching in peritoneal dialysis patients

There are several factors that can cause itching in peritoneal dialysis patients, including

High uric acid levels.

Elevated levels of uric acid in the blood, known as hyperuricemia, can cause itching in dialysis patients. High uric acid levels cause urate crystals to form, which can irritate the skin and cause itching and discomfort.

Dialysis-related factors

Itching can also be caused by other factors related to dialysis, such as the type of dialysis fluid used, the frequency and duration of dialysis sessions, and the presence of waste products in the body.

How to overcome itching

Several approaches can be used to overcome itching caused by high uric acid levels in peritoneal dialysis patients:

Medications.

Antihistamines.

Antihistamines can help reduce itching by blocking histamine, a substance released during an allergic reaction that causes itching and inflammation.

Topical corticosteroids

Applying a topical corticosteroid, such as hydrocortisone, can help reduce itching by reducing inflammation and irritation of the skin.

Uric acid lowering medications

Medications such as allopurinol and febuxostat can be used to lower uric acid levels in the blood and may help reduce itching in patients on peritoneal dialysis.

Lifestyle changes

Dietary adjustments

A low-purine diet can help lower uric acid levels in the body. This involves reducing your intake of foods such as red meat, organ meats, and seafood while increasing your intake of low-purine foods such as fruits, vegetables, and whole grains.

Maintain adequate hydration

Drinking enough water is essential for dialysis patients. Drinking plenty of water can help dilute uric acid levels in the blood and promote the excretion of uric acid through the urine. That said, you can't drink too much - you can literally only consume enough in limited amounts

Skincare and moisturizing

Skin care is very important in managing itching. Moisturizing your skin regularly using mild, fragrance-free products can help reduce dryness and irritation. Also, avoid using harsh soaps and hot water, as they can strip your skin of its natural oils and make itching worse.
Working with a dermatologist to get a prescription was a top priority in my personal situation

Dialysis adjustments

Adjust your dialysis schedule and retention time
Adjusting the frequency and retention time of your dialysis sessions can help relieve itching. Talk to your doctor about how to optimize your dialysis schedule to effectively remove waste and uric acid from your body.

Closing thoughts...

Itching caused by high uric acid levels in peritoneal dialysis patients can be a difficult and uncomfortable problem to deal with.  In fact, it can cause a lot of discomfort in your life because it recurs every time. Nevertheless, if you face the problem in a variety of ways, including medication, lifestyle changes, and adjusting your dialysis retention time, you can overcome it and improve your quality of life. Always consult your doctor before making any changes to your treatment plan.

It's all hard right now, but it can be overcome.

Q&A

Q: Is itching a common side effect of peritoneal dialysis?

A: Itching is a common issue among dialysis patients, including those undergoing peritoneal dialysis. It can be caused by various factors, such as high uric acid levels, dialysis-related factors, and skin dryness.

Q: Can I use over-the-counter creams to treat itching?

A: Over-the-counter hydrocortisone creams can help alleviate mild itching. However, it is essential to consult your healthcare provider before using any topical treatments, as some may not be suitable for your specific condition.

Q: How long does it take for uric acid-lowering medications to reduce itching?

A: The duration varies from person to person, but it may take several weeks for uric acid levels to decrease and itching to improve. It's essential to follow your healthcare provider's recommendations and continue taking medications as prescribed.

Q: What can I do if my itching does not improve despite making the suggested changes?

A: If you continue to experience itching despite implementing the strategies mentioned, consult your healthcare provider. They may recommend additional treatments or refer you to a specialist to address your specific needs.

Q: Are there any alternative treatments for itching in peritoneal dialysis patients?

A: Some patients may find relief from alternative therapies, such as acupuncture or relaxation techniques. However, it is crucial to discuss these options with your healthcare provider before trying them, as they may not be suitable for everyone.