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Hepatic and Renal Pruritus

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Dr Asit Kumar Mittal, Udaipur    21 January 2019

  • In recent years, there is an attempt to better understand mechanism of itch in systemic itch.
  • Disturbance in endogenous opioids both at the central and peripheral level is one of the proposed mechanisms.
  • Drugs-like gabapentin and pregabalin in low doses have shown maximum efficacy in itch of chronic kidney disease (CKD).
  • Antagonist such as naltrexone and agonist such as nalfurafine have shown efficacy in itch arising out of both kidney and liver disorders.
  • Other pharmacotherapies that have been attempted in hepatobiliary itch are rifampicin, cholestyramine and sertraline.
  • Ileal bile acid transporter inhibitors are some of the exciting new developments in treating hepatobiliary itch.

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