Intractable Pruritus as a Manifestation of Secondary Hyperparathyroidism in Uremia

Abstract

PRURITUS, a common symptom in uremic patients, is usually observed in the absence of visible skin lesions.^{1 , 2} The underlying cause of the itching in these patients is unknown, but the "toxic" effect of uremia has usually been implicated. However, improvement of the uremic state by adequate hemodialysis or peritoneal dialysis does not always relieve the itching, and in certain cases pruritus may even worsen,³ suggesting that factors other than uremia itself may be involved.We have previously observed the disappearance of severe pruritus after subtotal parathyroidectomy in two patients with chronic renal failure who were maintained with adequate hemodialysis.†³ This . . .