• Björn Wikström, Ryszard Gellert, Søren D Ladefoged, Yasuaki Danda, Masahiko Akai, Kaoru Ide, Midori Ogasawara, Yoshiharu Kawashima, Koki Ueno, Akio Mori, and Yuji Ueno.
• Department of Nephrology, Dialysis Unit, University Hospital, Uppsala, Sweden.
• J. Am. Soc. Nephrol. 2005 Dec 1; 16 (12): 3742-7.

AbstractUremic pruritus is a very common and frustrating condition for both patients and clinicians because no treatment has been demonstrated to be effective in relieving the itch. In this report, nalfurafine, a new kappa-opioid receptor agonist, was used to treat uremic pruritus in patients who were undergoing routine hemodialysis. Two multicenter, randomized, double-blind, placebo-controlled studies enrolled 144 patients with uremic pruritus to postdialysis intravenous treatment with either nalfurafine or placebo for 2 to 4 wk. A meta-analysis approach was used to assess the efficacy of nalfurafine. Statistically significant reductions in worst itching (P = 0.0212), itching intensity (P = 0.0410), and sleep disturbances (P = 0.0003) were noted in the nalfurafine group as compared with placebo. Improvements in itching (P = 0.0025) and excoriations (P = 0.0060) were noted for the nalfurafine-treated patients. Nalfurafine showed similar types and incidences of drug-related adverse events as did placebo. Nalfurafine was shown to be an effective and safe compound for use in this severely ill patient population.

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