Is the uremic pruritus related to indole metabolites?

Introduction: Several studies have shown that prevalence of chronic kidney disease remains important in the world. Uremic pruritus remains an stresfull symptom contributing to morbidity in people with chronic kidney disease. The aim of our study is to measure the plasma and skin levels of indole metabolites, which may be involved in the etiopathogenesis of this symptom, by grouping them according to the itching scales in hemodialysis patients and to show possible correlation. Results: The average age of the participants in our study was found to be 60.8 ± 14.8. In our study 32 (52.5%) of the participants are men and 29 (47.5%) are women. It was found that the participants in our study received an average of 4.6 ± 3.8 years and 54.9 ± 45.7 months of hemodialysis, respectively. The avarage blood hemoglobin value of the participants in our study was found to be 10.7 ± 1.7 and 11.2 ± 1.2 (g / dL) and 10.1 ± 1.9 in the patient and control groups, respectively. Plasma 2-3 pyridine dicarboxylic acid values of patient and control groups were found 142.18 ± 50.92 (µg / ml) and 72.08 ± 37.96 (µg / ml), respectively. There was a statistically significant difference between 2-3 pyridine dicarboxylic acid levels (p <0.001). The plasma indoxyl sulfate values of the patient and control groups were found to be 7.60 ± 2.59 (µg / ml) and 2.60 ± 0.98 (µg / ml), respectively. A statistically significant difference was found between indoxyl sulfate levels by groups (p <0.001). The plasma indoxyl β-D-Glucuronide levels of the patient and control groups were found to be 1.95 ± 1.36 (µg / ml) and 1.03 ± 1.20 (µg / ml), respectively. A statistically significant difference was found between indoxyl β-D-Glucuronide levels according to the groups (p <0.001). Discussion: In our study, 2-3 pyridine dicarboxylic acid levels in the patient group showing pruritus symptoms were found to be statistically significantly higher than the control group without pruritus. This situation shows that this finding of our study is compatible with the literature data. Our findings in other parameters are also compatible with the literature data. Conclusion: In patient with CKD, the etiology of uremic pruritus poses a challenge because it is multifactorial. Studies on this subject are important in terms of shedding light on the causes. Our study shed light on the relation between pruritus and indole metabolites. We hope that this study will lead more comprehensive studies on this subject.