الفهرس 
HemodialysisOnly 14 pages are availabe for public view
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Abstract
Gabapentin is a novel antiepileptic agent which modulates various receptor sites and alters dopamin, serotonin, and norepinephrine release. It has shown promising effects in the treatment of chronic neuropathic pain syndromes such as HIV-associated neuropathy, post herpetic neuralgia, and pain in diabetic neuropathy. Also, the utility of gabapentin in the management of uremic itch has been proposed in one trial.
So, the aim of the present study was to discover the influence of gabapentin administration on hemodialysis pruritis. Fifty patients on maintenance hemodialysis were included in the study. They were subdivided into two groups: the first group (GI) included 40 patients and were given gabapentin 300mg thrice weekly on attending hemodialysis session for 4 weeks while the second group (GII) received placebo in the same dosage. In addition, there were 10 patients complaining of pruritis for etiologies rather than hemodialysis (GIII) and received gabapentin.
Comparison of the demographic characteristics between the studied groups didn’t reveal statistically significant differences. Effects of daily activities on pruritis had shown that rest, dry skin, hot weather and sweat are the major factors exacerbating pruritis sensation while being busy, sleep, showering and cold weather are the main factors alleviating perception of pruritis.
In the present study, 40 patients (67%) had mild pruritis, while 12 patients (20%) had moderate pruritis and 8 patients (13%) had severe pruritis. In the present study, there were no associations between pruritis severity and score and the demographic characteristics and the clinical and laboratory findings apart from the fact that improved hemodialysis adequacy was associated with less pruritis scores and severity, an important findings in the present study is the significant direct correlation between CRP and the intensity of pruritus.
Basically, there were no statistically significant differences among the studied groups regarding pruritis severity and pruritis score before treatment. After treatment, GI had significantly lower pruritis severity and scores when compared with the other two groups. Comparison between pruritis severity before and after treatment in group I had shown statistically significant improvement. In contrast to GII and GIII that showed no statistically significant improvement with time except the three patients in GIII with unknown cause of prurites who show some improvement.
Regarding the reported side effects for gabapentin use in the studied patients, it was noted that somnolence, dizziness and fatigue were the commonest reported symptoms.
In conclusion, gabapentin proved effective in treatment of uremic pruritis with minimal side effects.