透析患者相关瘙痒防治研究进展
Research Advances in the Prevention and Treatment of Dialysis-Related Pruritus Patients
DOI: 10.12677/acm.2025.15123517, PDF,    科研立项经费支持
作者: 李 双, 何晓娇, 刘 岩*：暨南大学附属广州红十字会医院肾内科，广东 广州
关键词: 慢性肾脏病相关性瘙痒；透析相关性瘙痒；环氧乙烷；Chronic Kidney Disease-Associated Pruritus； Dialysis-Related Pruritus； Ethylene Oxide
摘要: 透析(dialysis)患者皮肤瘙痒是指发病与透析明显相关的瘙痒症状，它不同于尿毒症性瘙痒(Uremic Pruritus)，更不能用慢性肾脏病相关瘙痒(Chronic Kidney Disease Associated Pruritus, CKD-aP)来代替。终末期肾病瘙痒一般在接受透析治疗后会有明显好转甚至消失。透析相关性瘙痒(dialysis-related pruritus)发生率为40%至84%，据上世纪80~90年代研究，其发病与透析材料和消毒用的环氧乙烷(Ethylene Oxide, ETO)有关，因血液透析患者皮肤瘙痒缺乏明确机制，严重影响患者的生活质量甚至生存率。基于临床观察和历史研究线索，本文提出透析相关性瘙痒的环氧乙烷致敏–免疫调节双路径假说，论证消毒剂残留与免疫微环境紊乱的协同致病机制，为透析患者皮肤瘙痒的预防和治疗提供一些新思路。
Abstract: Dialysis-related pruritus refers to itching symptoms that are clearly associated with dialysis. It is distinct from uremic pruritus and should not be confused by chronic kidney disease-associated pruritus (CKD-aP). Itchiness in end-stage renal disease usually shows significant improvement or even disappears after the initiation of dialysis treatment. The incidence of dialysis-related pruritus ranges from 40% to 84%. Historical studies in the 1980s and 1990s suggested that its pathogenesis is related to dialysis materials and ethylene oxide (ETO), which is used for sterilization. However, the explicit mechanism underlying skin itching in hemodialysis patients remains elusive, severely impacting patients’ quality of life and even their survival rates. Based on my clinical observations and references to relevant historical studies, I have written this non-systematic review, hoping to provide some meaningful clues for the prevention and treatment research of skin itching in dialysis patients.
文章引用：李双, 何晓娇, 刘岩. 透析患者相关瘙痒防治研究进展[J]. 临床医学进展, 2025, 15(12): 1170-1175. https://doi.org/10.12677/acm.2025.15123517

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