Chronic Kidney Disease-Associated Pruritus in Hemodialysis: Unraveling Mechanisms and Emerging Therapeutic Targets-A Systematic Review.

ABSTRACT: This systematic review examines chronic kidney disease-associated pruritus (CKD-aP) as a complex clinical manifestation in patients undergoing hemodialysis. Traditionally considered a secondary symptom of end-stage renal disease, emerging evidence now positions CKD-aP as a multidimensional disorder with substantial pathogenic influence on patient outcomes. Using the PRISMA 2020 methodology, we critically evaluated 54 peer-reviewed studies published between 2020 and 2025. Our synthesis highlights a convergence of five mechanistic frameworks underpinning CKD-aP: elevated levels of uremic toxins originating from gut microbial dysbiosis, immune activation driven by IL-31 and other pro-inflammatory cytokines, heightened peripheral and central neural sensitization, dysregulation of endogenous op

SUBMITTER: Dragos F 

PROVIDER: S-EPMC12840920 | biostudies-literature | 2026 Jan

REPOSITORIES: biostudies-literature