Effectiveness of Ketotifen in Treating Uremic Pruritus

Abstract

Introduction Among the commonest distressing complaints in patients with chronic kidney disease, is itching. We conducted a prospective study to assess the efficacy of ketotifen, a putative.mast.cell.stabilizer, in patients with uremic itch refractory to traditional.treatment.Materials and Methods A double-blind.randomized.trial with a crossover.design was applied on 25 patients .In all of these patients,causes of itching other than uremia had been excluded. We divided the patients into two groups A and B ; they received either oral ketotifen, 1 mg, twice a day for 2 week or placebo for the same period . After A one week period of washout, each group was conversely treated. The response was assessed by the patients subjectively by a questionnaire to assess their itching is either totally relieved ,partially relieved, or still the same (no effect).Results nine patients (36%) reported totally relieved itching with ketotifen and none (0%) with placebo (P =.003). Partial relieve was reported in 15 (60%) and 16 (64 %), respectively. One patient (4%) with ketotifen and nine patients (36%) with placebo showed no change in their symptoms.. Eleven patients (44%) suffered from drowsiness that decreased spontaeously in all them after average 5 days. Conclusions in this study,we postulate that ketotifen, a putative.mast.cell.stabilizer, can be employed to relieve pruritus refractory to other traditional therapies in chronic kidney disease patients who were on maintenence hemodialysis. A moderate dose of ketotifen was effective while safe despite its major side effect, drowsiness, which was transient and could be well accepted by uremic subjects.