Use of sertraline for antihistamine-refractory uremic pruritus in renal palliative care patients

J Palliat Med. 2013 Aug;16(8):966-70. doi: 10.1089/jpm.2012.0504. Epub 2013 Jun 18.

Abstract

Background: Uremic pruritus is a common and distressing symptom occurring in 42% to 75% of end-stage renal dialysis (ESRD) patients, even in patients who are adequately dialyzed.

Methods: We conducted a retrospective review of consecutive patients who presented to the renal palliative care clinic in a single institution with pruritus refractory to antihistamines between April 2011 and September 2012. A total of 99 patients were screened during this period; 20 were eligible for this study. Sertraline was initiated at 25 mg daily orally for the first month, with dosage increment of 25 mg monthly according to clinical response up to a maximum of 200 mg daily as necessary. Patients were followed up every 2 to 4 weeks in the renal palliative care clinic.

Results and conclusions: Study results showed that low-dose sertraline was effective for antihistamine-refractory uremic pruritus in renal palliative care patients. Further placebo-blinded randomized-controlled studies are warranted to clarify our findings.

MeSH terms

  • Administration, Oral
  • Aged
  • Aged, 80 and over
  • Antidepressive Agents / administration & dosage
  • Antidepressive Agents / adverse effects
  • Antidepressive Agents / therapeutic use
  • Female
  • Humans
  • Kidney Failure, Chronic / complications*
  • Male
  • Middle Aged
  • Palliative Care / methods*
  • Pruritus / drug therapy*
  • Pruritus / etiology
  • Retrospective Studies
  • Sertraline / administration & dosage*
  • Sertraline / adverse effects
  • Sertraline / therapeutic use
  • Treatment Outcome

Substances

  • Antidepressive Agents
  • Sertraline