Evaluation of the Effect of Gabapentin in the Management of Uremic Pruritus in Hemodialysis Patients

Jalal Azmandian; Mosayyeb Kouhkan; Seyed Mojtaba Sohrevardi

doi:10.18502/aptj.v3i2.13462

Jalal Azmandian Physiology Research Center and School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
Mosayyeb Kouhkan Pharmaceutics Research Center, School of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
Seyed Mojtaba Sohrevardi Department of Clinical Pharmacy, School of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran and Stroke Prevention and Atherosclerosis Research Center, University of Western Ontario, London, Canada

DOI: https://doi.org/10.18502/aptj.v3i2.13462

Keywords: Gabapentin, Hemodialysis, Pruritus

Abstract

Background: Gabapentin is an antiepileptic agent that has analgesic properties in neuropathic pain. Given that few studies have assessed the effect of the low dose of gabapentin on uremic pruritus, this study aimed to evaluate the effect of gabapentin on pruritus of hemodialysis patients.

Materials and Methods: This clinical trial study was conducted on dialysis patients who were referred to Shafa Hospital, Kerman. In this regard, 40 patients consumed 100 mg of gabapentin for one week. Then patients did not take any medication within the washout period and consumed a 100 mg placebo for one week. Assessment of pruritus severity was done by visual analog scale (VAS). Hematocrit, calcium, phosphor, creatinine, and albumin were evaluated. These measurements were done before and after treatments with placebo and gabapentin.

Results: The main places of pruritus location in dialysis patients were the back (90 %), abdomen (80%), shoulder (80%), and head (70%). The mean pruritus severity before treatment, and after treatment with placebo and gabapentin, was 8.3± 1.5, 6.73 ± 1.17, and 4.58 ± 1.50, respectively. Significant difference was seen before and after treatment, in terms of pruritus severity (p<0.1). In addition, there was a significant difference between gabapentin and placebo groups, regarding the severity of pruritus (p<0.1). No significant difference was seen before and after treatment, regarding biochemical parameters (p>0.05).

Conclusion: According to the findings, it seems that gabapentin can be an effective and safe treatment for pruritus in patients on hemodialysis. The therapeutic approach chosen for these patients is based on the neuropathic hypothesis.