CHRONIC KIDNEY DISEASE ASSOCIATED PRURITUS IN CHILDREN – DIAGNOSIS DILEMMA AND TREATMENT

Roxana Alexandra Bogos, Tudor Ilie Lazaruc, Ileana Ioniuc, Ana Maria Laura Buga, Anca Lavinia Cianga, Georgiana Scurtu, Laura Stefana Galatanu, Maria Adriana Mocanu

ABSTRACT

Pruritus represents a common and distressing feature of patients with chronic kidney disease (CKD). The severity of CKD associated pruritus (CKD-aP) can be assessed by using a visual analogue scale. Its presence is associated with a decreased quality of life, it contributes to the onset of other symptoms, it is correlated with depression, and represents an independent predictor of mortality. The aim of this article is to present the case of a 16 years old patient with end stage renal disease who developed CKD-aP in evolution, along with the apparition of other dermatological findings. Despite the adaptation of the dialysis prescription, the patient developed a severe uremic pruritus. Partial failure of numerous topical therapies associated with neuroleptics and sedatives was registered. The non-compliance to diet contributed to a slow amelioration of the symptoms. We highlight the importance of the correction of dialysis adequacy, phosphorus and calcium levels, along with skin hydration, nutrition, and patient education in an optimal outcome for pediatric patients with CKD-aP

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