Topical Treatments for Uremic Pruritus in Hemodialysis Patients: A Systematic Review

Background & Objective: Pruritus is a common disruptive symptom in hemodialysis patients and those with chronic renal failure. Although pharmacological treatments could partially reduce pruritus in hemodialysis patients, the definitive treatment remains challenging in these patients. Several studies have been published in this regard, while no reviews have been focused on these articles. The present study aimed to review the topical treatments for pruritus. Material and Methods: This review study was conducted on the Persian and English articles published during 1987-2018 via searching in databases such as SID, PubMed, Google Scholar, Scopus, Barakat Knowledge Network System, Elsevier, Springer, Web of Science, Magiran, HerbMed, and Biomed Central. In total, 217 articles were retrieved, and 63 articles were initially selected after screening the titles, and 12 articles were eliminated after reviewing the abstract. Among the remaining articles (n=51), the original texts were assessed, and 20 studies were excluded due to irrelevance to the research subject. Finally, 31 articles were reviewed using the Jadad checklist, and 25 articles had good mean (scores above 3), which were included in the study. Results: The most effective topical treatments reported for hemodialysis patients include the use of emulsions, gels, ointments, creams, oil, and lotions. A review of these studies indicated that ointment is most effective in relieving itching, followed by creams, gels, oils, and lotions, and emulsions, which are also helpful in reducing itching in hemodialysis patients. Conclusion: According to the results, the use of topical remedies (e.g., herbal oils, gels, ointments, creams, emulsions, and lotions) could be effective in the treatment of itching in hemodialysis patients, and these methods are highly recommended in this regard.