Chronic itching and its relation to the kidneys: Medical warnings and symptoms you shouldn't ignore
The skin is a mirror reflecting the health of the body's internal organs, and skin changes are often the first warning signs of silent diseases that can worsen if neglected. In this context, Dr. Shadi Amr, a consultant in internal medicine and nephrology, issued an important medical warning in the newspaper "Al-Youm," emphasizing the need to not ignore chronic itching that does not respond to traditional treatments, as it may be a strong indicator of serious kidney dysfunction.
Uremic pruritus: More than just a skin symptom
Dr. Amr explained that itching associated with kidney disease, medically known as uremic pruritus, is fundamentally different from typical skin allergies. Historically, this symptom was considered a mere side effect of kidney failure, but recent studies have shown that persistent itching directly and profoundly impacts a patient's quality of life and their physical and mental well-being. This condition often appears in patients with chronic kidney disease and is characterized by several distinguishing features, including the absence of an initial rash and its intensification during the night, causing severe sleep disturbances.
Physiological causes and toxin accumulation
In explaining the underlying causes of this phenomenon, the consultant clarified that when the kidneys lose their ability to filter the blood, toxins and nitrogenous waste accumulate in the body. This accumulation, along with an imbalance of vital minerals such as calcium and phosphorus, and elevated parathyroid hormone levels, stimulates nerve endings in the skin, causing an unbearable itching sensation. He added that severe skin dryness and the neurological changes associated with kidney disease play a pivotal role in exacerbating the condition, often rendering conventional antihistamines ineffective.
Warning signs and when should you see a doctor?
Dr. Shadi Amr identified a set of red flags that require immediate medical intervention, including:
- The itching persists for several weeks without a clear external cause (such as insect bites or a change in laundry detergents).
- The itching is accompanied by general symptoms such as persistent fatigue, swelling of the feet or face, and changes in the amount or color of urine.
- The appearance of bloody scratch marks as a result of continuous scratching without the presence of blisters or a previous rash.
He stressed that early diagnosis through kidney function tests and measuring salt and mineral levels in the blood is the first and essential step to controlling the disease and preventing its complications.
Modern treatment strategies and lifestyle changes
Regarding treatment protocols, Dr. Amr pointed out that modern medicine offers multiple options beyond regular soft drinks. Treatment begins with managing the underlying disease (kidney failure) and strictly controlling the diet to reduce phosphorus intake (avoiding dark sodas, processed foods, and certain dairy products). Medical soft drinks containing urea are also used, along with advanced medications that calm the nerves, such as gabapentin, and even specialized, modern treatments like the drug Difelikefalin, which is specifically formulated for these conditions.
He concluded by emphasizing that health awareness of these symptoms may be the difference between discovering kidney failure at a manageable stage and reaching late stages that require dialysis, calling on patients to take their body's signals seriously.
