Narrow Band UVB Phototherapy for the Treatment of Refractory Renal Pruritus among Patients on Hemodialysis

Abusailik , Mohammad; Alhasanat , Abdullah; Hamadeneh , Khaled; Fawwaz , Al Sharif Mohammad; Almuhisen , Adam; Nawaiseh , Mohammed

doi:10.12816/0058878

Article Details

Narrow Band UVB Phototherapy for the Treatment of Refractory Renal Pruritus among Patients on Hemodialysis

Authors:

Abusailik , Mohammad | Alhasanat , Abdullah | Hamadeneh , Khaled | Fawwaz , Al Sharif Mohammad | Almuhisen , Adam | Nawaiseh , Mohammed

Publisher:

Jordanian Medical services - Jordanian Armed Forces

Main Topics:

Medicine

Journal:

Journal of the Royal Medical Services 2021 Vol.28 Issue 1, pp.38-53

Document Type:

Article

Publication Date:

4/2021

Document Language:

English

Document ID (Org No.):

234893

Frequency:

Quarterly

eISSN:

20788711

pISSN:

20788703

DOI:

10.12816/0058878

Descriptors:

Keywords:

Abstract:

 Objective: To assess the efficacy of narrowband ultraviolet B phototherapy for the treatment of refractory renal pruritus among patients on hemodialysis.
Methods: This prospective multi-centered cohort study included 106 adult patients with renal failure on maintenance hemodialysis. These patients who presented with severe renal pruritus unresponsive to previous therapies, were treated with narrowband ultraviolet B phototherapy three times a week for four months. The initial therapeutic ultraviolet B dose was dependent on the skin phototype. The dose was increased by 20% if erythema appeared or by 40% if it did not. Evaluation of pruritus was carried out monthly during treatment and three months following treatment cessation using the 12-Item pruritus severity scale (PSS).
Results: There was a significant improvement in the degree of pruritus in the first three months of phototherapy. However, the improvement at the fourth visit was not significant. Pruritus severity scale decreased from a mean of 19.1 ± 1.9 at the initiation of phototherapy to 9.2 ± 3.9 at the end of treatment (P < .001), but increased to 12.9 ± 4.0 three months after cessation of treatment. The overall response rate was 78%. Although the relapse rate was 52%, the overall improvement from pretreatment state was significant (p < .001).
Conclusion: Since there was no significant improvement after the third visit and given that there was a high relapse rate after treatment discontinuation, we recommend starting an induction therapy (3 times a week) in the first three months, then continuing for maintenance therapy with the possibility of combining phototherapy with other systemic therapies. Narrowband ultraviolet B phototherapy is highly effective for the treatment of renal pruritus, but the clinical response is short-lived with a high relapse rate after discontinuation of phototherapy.

Article Details

Narrow Band UVB Phototherapy for the Treatment of Refractory Renal Pruritus among Patients on Hemodialysis

Authors:

Abusailik , Mohammad | Alhasanat , Abdullah | Hamadeneh , Khaled | Fawwaz , Al Sharif Mohammad | Almuhisen , Adam | Nawaiseh , Mohammed

Publisher:

Jordanian Medical services - Jordanian Armed Forces

Main Topics:

Medicine

Journal:

Journal of the Royal Medical Services 2021 Vol.28 Issue 1, pp.38-53

Document Type:

Article

Publication Date:

4/2021

Document Language:

English

Document ID (Org No.):

234893

Frequency:

Quarterly

eISSN:

20788711

pISSN:

20788703

DOI:

10.12816/0058878

Descriptors:

KIDNEY DISEASES

HAEMODIALYSIS

ULTRAVIOLET RADIATION

RADIOTHERAPY

Phototherapy

Narrowband UVB

Renal Pruritus

Pruritus Severity Scale

Chronic Kidney Disease-Associated Pruritus

Issues

Article Details

Authors: Abusailik , Mohammad | Alhasanat , Abdullah | Hamadeneh , Khaled | Fawwaz , Al Sharif Mohammad | Almuhisen , Adam | Nawaiseh , Mohammed

Publisher: Jordanian Medical services - Jordanian Armed Forces

Main Topics: Medicine

Journal: Journal of the Royal Medical Services 2021 Vol.28 Issue 1, pp.38-53

Document Type: Article

Publication Date: 4/2021

Document Language: English

Document ID (Org No.): 234893

Frequency: Quarterly

eISSN: 20788711

pISSN: 20788703

DOI: 10.12816/0058878

Descriptors:

Issues

Authors:

Abusailik , Mohammad | Alhasanat , Abdullah | Hamadeneh , Khaled | Fawwaz , Al Sharif Mohammad | Almuhisen , Adam | Nawaiseh , Mohammed

Publisher:

Jordanian Medical services - Jordanian Armed Forces

Main Topics:

Medicine

Journal:

Journal of the Royal Medical Services 2021 Vol.28 Issue 1, pp.38-53

Document Type:

Article

Publication Date:

4/2021

Document Language:

English

Document ID (Org No.):

234893

Frequency:

Quarterly

eISSN:

20788711

pISSN:

20788703

DOI:

10.12816/0058878