CAN THE AGGRAVATION OF PRURITUS BE A SIGN OF WORSENING PERIPHERAL NEUROPATHY IN UREMIC DISEASE? A CLINICAL AND NEUROPHYSIOLOGICAL STUDY

Introduction: Neuropathy is a frequent complication of uremic disease, causing motor and sensorial symptoms, mostly localized in the lower limbs. Another symptom related to uremic disease is pruritus, which may be diffuse all over the body, but usually occurring in the lower limbs. In the terminal phase therapeutic measures are taken, targeting the sensitive components of neuropathy, with the use of drugs against pain, and targeting itching, using different substances, the most widely used of which is gabapentin. Methods: The severity of neuropathy is variable, ranging from slight to severe and may or may not be associated with the length of chronic dialysis treatment. The use of measurement scales of pain, VAS type adapted to the itching, may link both conditions of neuropathy and itching. Results: We noted that a severe intensity of pruritus can be related to severity of neuropathy in uremic subjects and may become predictive of progressing neuropathy. Conclusions: In this study we examined a group of uremic subjects, clinically and with neurophysiological investigations, discovering a remarkable association between the intensity of pruritus and the severity of neuropathy. Pruritus can be considered a marker of progressing neuropathy and it might to be helpful in undertaking more effective therapeutic strategies.