Kidney failure is a condition of when the kidney doesn’t work as well as it should. This can be mild or severe. To keep survive – you need at least one functioning kidney. In the worst scenario, two kidneys completely fail to work (end-stage renal disease). For such case, dialysis is recommended. Skin itching is quite common in people with kidney disease, particularly for those with dialysis.
Pruritus is the medical name to call itching. It is unpleasant, discomfort sensation that compels you to scratch the affected area. It may be the result of dermatitis or another condition like rash or psoriasis. It may also be a consequence of particular disease such as kidney problem or liver disease.
Causes of itchy skin
There are a number of different conditions that can contribute to cause itchy skin. The common causes include:
- Systemic conditions such as thyroid problems, liver disease, and kidney failure.
- Excessive skin reactions (allergies).
- Skin conditions, like eczema.
- Parasitic infestations, like scabies (contagious skin condition, typically caused by tiny mites).
- Infections, such as fungal infection in athlete’s foot.
- Minor irritation, such as due to insect bites and stings.
- Changes in hormones such as during menopause and pregnancy.
The problem can affect any area of the body. It can be localized or generalized. Localized means it occurs in particular areas of the body. Generalized means it affects over the whole body.
The affected area can be normal, dry, rough, or red. Sometime it may also have blisters or bumps. This is dependent on the cause of the problem and how severe it is.
Many times, itchiness is a mild condition. But if it becomes chronic or acute, this may affect the quality of your life. For instance, chronic itching may interfere with the quality of your sleep. And lack of sleep is associated with a number of different conditions.
The problem can be very bothersome. Although some treatments are available, it’s not always easy to cope. As you scratch the affected area, it can itch even more! And the more it gets itchy – the more you rub or scratch, causing itch-scratch cycle that is difficult to break!
Prolonged itching can get worse over time. If it is poorly controlled or left untreated, this may cause skin infection, injury, or scarring.
How common is itchy skin in kidney disease?
Some patients with kidney disease have leg cramps, some experience lethargy, and some have loss of appetite. Other symptoms include insomnia (sleep problem), bone fractures (weak bone), joint problem, and restless leg syndrome.
Itching is also a common symptom of kidney disease. About one-third of patients with kidney problem experience this discomfort sensation, again especially those who are on dialysis. Even it affects about half patients with advanced kidney disease (particularly those with end-stage renal failure), according to a report of the American Academy.
Itching all over or in particular areas of the body
Itchy skin associated with internal diseases can affect the whole body (generalized). Kidney failure can cause itching all over the body. But sometime it also occurs in particular areas of the body.
For instances, many patients who are on hemodialysis often report discomfort itchy skin on the chest, back, head, and limbs (hands, arms, or legs). And those with uraemic pruritus (itching associated with excessive urea in the blood due to poor kidneys function), the itch may be localized or generalized.
Furthermore, the flare-up of the problem can vary from patient to patient. Many times, it is worse a few days after dialysis treatment. But some patients may also find that it is worse during or just after the treatment.
This issue is not fully known, but there are some explanations. Even the way of the body gives the urge to scratch is also not completely understood yet (it is very complex).
Kidney failure may cause itching in several ways. But in general, the failure of the kidneys in removing wastes and keeping the balance of particular substances in the body is to blame – though there are also other factors that may have an effect.
The imbalance of calcium
The poor kidney function cannot regulate the balance of minerals in the blood as well. There is a chance for patients to have the imbalance of blood calcium. Too low calcium in the bloodstream stimulate parathyroid glands (4 pea-sized glands in your neck) to make and release more parathyroid hormones.
Parathyroid hormone pulls calcium from the bone to cope with the deficiency, increasing the risk of bone fractures. In fact, osteoporosis is one of common complications from kidney damage.
High amount of parathyroid hormone can lead to itching, too! Some patients find that it’s helpful to remove most of their parathyroid glands. Although this treatment option has drawbacks, but the balance of calcium is easier to manage and there is usually nothing to worry as long as one parathyroid gland remains.
Another treatment is the use of medications with vitamin D or other medicines that can help decrease parathyroid hormones (such as Sensipar). For more guidance, ask your doctor!
The imbalance of phosphorus (phosphate)
High amount of phosphate in the blood is common in people with advanced kidney disease or those who are on dialysis. Again, the damaged kidneys’ inability to regulate the balance of minerals (including phosphate) is to blame. Many times, it doesn’t come with symptom. But it may also lead to generalized itching.
Treatment options include:
- Optimize the dialysis treatment (make sure it is working effectively)!
- Diet low in phosphate. Skip foods high in phosphate such as soda, milk, cheese, ice cream, processed foods (fast foods), dried peas, etc. Work with a professional dietitian for more advice!
- Decrease the absorption of phosphate! There are some medications that can help bind phosphorus in the bowel, making it more difficult to absorb and go into the blood.
Uraemic pruritus is common in patients with chronic kidney disease. It affects about one-third of people on kidney dialysis, particularly those who take haemodialysis .
It can cause daily bouts of itching. Many times, it gets worse at night and this may also cause sleep problem. The itch may be localized or generalized.
Some experts believe that uraemic pruritus may be attributed by a number of different factors. Your risk is particularly high if you are on dialysis and also have some of the following factors: