INTRODUCTION Uremic pruritus is a multifactorial devastating complication of renal failure, which has a significant negative impact on patients' quality of life including medical, psychological, as well as social aspects. It is also associated with an increased mortality in dialysis patients. METHODS A cross sectional study evaluating the traditional risk factors for uremic pruritus (UP) - using pruritus grading system (PGS) and visual analogue scale (VAS) - as well as measuring the serum levels of different inflammatory cytokines (ILs 13, 31 and 33) in chronic hemodialysis and healthy controls, in a tertiary referral hospital. RESULTS 65 hemodialysis (HD) patients and 49 heathy controls were enrolled in the study. The mean age for the HD patients was 43.4 years (SD ± 21.3), and 31.5 years (SD ± 11.1) for the control group. The most common cause for End Stage Renal Disease (ESRD) was diabetes mellitus (DM) 27.7%. The mean PGS score in HD patients was 5.92 (SD ± 2.9); 50% had mild itch, 43.8% moderate itch and 6.2% had severe itch. The mean serum levels for IL-13 was 8674.3 pg/ml (SD ± 4353.9), serum levels of IL-31 were 150.7 pg/ml (SD ± 178.2) and for IL-33 it was 42850.5 pg/ml (SD ± 11370.7) in hemodialysis patients; in comparison to serum levels of 7913.4 pg/ml (SD ± 3454.1), 67.1 pg/ml (SD ± 71.9) and 44875.9 pg/ml (SD ± 12114.6), respectively in the control group. IL-31 level was significantly higher in HD patients than in the control group (P = 0.0001), while the difference in the levels of IL-13 and IL-33 between the two groups were not statistically significant (P = 0.41 and 0.18, respectively). IL-13 had a statistically significant relationship with the itch score (P = 0.014) and the severity of itch (P = 0.03), while IL-31 and IL-33 were not statistically significant. CONCLUSION UP is a complex and multifactorial problem. In patients with UP the high levels of IL-31 indicates a possible role in pathogenesis. IL-13 serum level on the other hand may be related to the severity of itch in these patients. Optimizing dialysis and targeting these cytokines may provide a potential therapeutic option especially in refractory UP. Further studies addressing these cytokines and their levels in response to various treatments may provide additional information on UP.

中文翻译：

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血液透析患者血清白细胞介素 31 水平升高与尿毒症瘙痒有关

引言尿毒症瘙痒是肾功能衰竭的多因素破坏性并发症，对患者的生活质量包括医疗、心理和社会方面有显着的负面影响。它还与透析患者的死亡率增加有关。方法 一项横断面研究评估尿毒症瘙痒 (UP) 的传统危险因素 - 使用瘙痒分级系统 (PGS) 和视觉模拟评分 (VAS) - 以及测量不同炎性细胞因子 (ILs 13、31 和 33) 的血清水平) 在三级转诊医院进行慢性血液透析和健康对照。结果 65 名血液透析 (HD) 患者和 49 名健康对照者参加了研究。HD 患者的平均年龄为 43.4 岁 (SD ± 21.3)，对照组为 31.5 岁 (SD ± 11.1)。终末期肾病 (ESRD) 的最常见原因是糖尿病 (DM)，占 27.7%。HD 患者的平均 PGS 评分为 5.92 (SD ± 2.9)；50%为轻度瘙痒，43.8%为中度瘙痒，6.2%为重度瘙痒。IL-13 的平均血清水平为 8674.3 pg/ml (SD ± 4353.9)，IL-31 的血清水平为 150.7 pg/ml (SD ± 178.2)，IL-33 为 42850.5 pg/ml (SD ± 11370.7) ) 在血液透析患者中​​；与对照组的血清水平分别为 7913.4 pg/ml (SD ± 3454.1)、67.1 pg/ml (SD ± 71.9) 和 44875.9 pg/ml (SD ± 12114.6) 相比。HD患者IL-31水平明显高于对照组（P=0.0001），而两组间IL-13和IL-33水平差异无统计学意义（P=0.41和0.18，分别）。IL-13与瘙痒评分（P = 0.014）和瘙痒严重程度（P = 0.03）有统计学意义的关系，而IL-31和IL-33无统计学意义。结论 UP 是一个复杂且多因素的问题。在 UP 患者中，高水平的 IL-31 表明可能在发病机制中发挥作用。另一方面，IL-13 血清水平可能与这些患者瘙痒的严重程度有关。优化透析和靶向这些细胞因子可能会提供一种潜在的治疗选择，尤其是在难治性 UP 中。针对这些细胞因子及其对各种治疗的反应水平的进一步研究可能会提供有关 UP 的更多信息。在 UP 患者中，高水平的 IL-31 表明可能在发病机制中发挥作用。另一方面，IL-13 血清水平可能与这些患者瘙痒的严重程度有关。优化透析和靶向这些细胞因子可能会提供一种潜在的治疗选择，尤其是在难治性 UP 中。针对这些细胞因子及其对各种治疗的反应水平的进一步研究可能会提供有关 UP 的更多信息。在 UP 患者中，高水平的 IL-31 表明可能在发病机制中发挥作用。另一方面，IL-13 血清水平可能与这些患者瘙痒的严重程度有关。优化透析和靶向这些细胞因子可能会提供一种潜在的治疗选择，尤其是在难治性 UP 中。针对这些细胞因子及其对各种治疗的反应水平的进一步研究可能会提供有关 UP 的更多信息。