Therapeutic effect of intravenous sodium thiosulfate for uremic pruritus in hemodialysis patients

Ren Fail. 2020 Nov;42(1):987-993. doi: 10.1080/0886022X.2020.1822867.

Abstract

Objectives: This study aimed to compare the efficacy of intravenous sodium thiosulfate (IV STS) with that of loratadine in the treatment of uremic pruritus in hemodialysis (HD) patients.

Methods: This retrospective study included 44 HD patients with pruritus aged over 18 years between June 2018 and January 2020 at the Aerospace Center Hospital of China. Twenty-four HD patients received 3.2 g IV STS treatment three times per week at the end of each HD session for 8 weeks. Twenty HD patients received loratadine (10 mg/day) for 8 weeks. Pruritus intensity was measured using a visual analog scale (VAS) and the detailed pruritus score (DPS) at three time points. The safety of STS was evaluated according to adverse event symptoms and biological variable changes.

Results: There was no significant difference between the STS and loratadine groups in age, sex, characteristics of pruritus, or other clinical variables before treatment. After 8 weeks of treatment, the VAS score (7.07 ± 2.56 and 2.67 ± 2.01) and DPS (30.72 ± 4.81 and 8.04 ± 2.86) decreased significantly in the STS group (p < 0.05). The mean decrease in VAS score (6.89 ± 1.98 and 6.34 ± 2.35) and DPS (28.90 ± 3.24 and 26.92 ± 2.41) in the loratadine group was not statistically significant (p > 0.05). There were no morbidities or mortalities associated with the use of either drug. All biological variables remained stable after therapy.

Conclusions: STS can improve uremic pruritus in HD patients. However, literature on the subject remains lacking. Close monitoring for adverse effects is advised.

Keywords: Sodium thiosulfate; dialysis; pruritus; pruritus score; visual analog scale.

MeSH terms

  • Administration, Intravenous
  • Adult
  • Aged
  • Aged, 80 and over
  • China
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pruritus / drug therapy*
  • Pruritus / etiology*
  • Renal Dialysis*
  • Retrospective Studies
  • Thiosulfates / administration & dosage*
  • Thiosulfates / adverse effects
  • Uremia / blood
  • Uremia / complications*
  • Uremia / therapy
  • Visual Analog Scale

Substances

  • Thiosulfates
  • sodium thiosulfate