Relation of Serum Aluminum Level to Uremic Pruritus in ESRD Patients on Maintenance Hemodialysis

Abstract

Uremic pruritus is a common agonizing although mostly overlooked symptom in end stage renal disease (ESRD) patients maintained on regular hemodialysis (HD). It impacts the quality of life and is associated with increased mortality in HD patients. The pathogenesis of Uremic pruritus is complex, CKD-aP has very variable wide range of aetiologies. different Data shows that CKD-aP prevalence ranges from 20% to as high as 90%. The prevalence has been reported to vary significantly among different settings. However, the prevalence has been observed to decline due to the availability of better dialysis facilities, different dialysis modalities, access, and adequacy. The prevalence also depends on the mode of dialysis, i.e., HD or peritoneal dialysis (PD) ‏Aluminum (Al) is a common metal that is toxic to patients undergoing HD and also is a common human allergen which can cause immune reaction. Despite that severe (Al) toxicity in patients on maintenance HD is now uncommon due to the removal of (Al) from water used for dialysis by reverse osmosis and deionization as well as the use of widely available non-aluminum-containing phosphate binders. However, controlling serum (Al) levels remains an important issue for patients on regular HD. The possible sources of aluminum