Uremic pruritus is itching that many people with chronic or end-stage kidney disease experience. It doesn’t cause any noticeable skin changes that account for the itching. Causes might include toxins, immune system changes or nerve issues. Adjusting your dialysis or taking medications that reduce itchy signals from your nerves might help treat it.
Uremic pruritus is itching experienced by people with chronic kidney disease (CKD) and end-stage kidney disease (ESKD). There’s no skin rash that causes the itching and it’s often not specific to any part of your body.
The itching can:
Despite the name, it’s not clear whether you have to have uremia (a buildup of toxins in your blood) to experience this kind of itching. Uremic pruritus is also called chronic kidney disease-associated pruritus (CKD-aP) or end-stage renal disease-associated chronic itch (ESRDCI).
People on dialysis (hemodialysis or peritoneal dialysis) are more likely to experience uremic pruritus than those not on dialysis. Studies on additional risk factors have conflicting results. Some show that people older than 70 are more likely to have uremic pruritus and are more likely to have severe itching.
Up to 70% of people who receive hemodialysis experience some degree of itching. Around 25% of people with chronic kidney disease who aren’t on dialysis also have uremic pruritus.
Many people with uremic pruritus itch all over or on large areas of their body. Your back, face and shunt arm (where you receive dialysis) are the most common specific places you might itch.
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If you have CKD or ESKD and are experiencing itching, your provider will first look for other causes. They’ll check your skin for a rash or other changes. They might order blood tests. They’ll diagnose you with uremic pruritus if they rule out other causes.
Experts aren’t sure why people with CKD and ESKD experience itching. Things that might contribute include:
There’s no single treatment for uremic pruritus that works for everyone. Some available treatments include:
Scientists are studying other treatments for uremic pruritus to test their effectiveness.
Talk to your provider about what you can do to safely treat itching at home. You might find keeping your skin moisturized or using anti-itch lotions gives you some relief. Experts don’t usually recommend using antihistamines (like allergy medicines) in most cases. These don’t seem to work very well for uremic pruritus and can cause side effects.
Constant itching can affect both your physical and mental health. Scratching can damage your skin and lead to infection. Persistent itching can keep you from sleeping and affect your quality of life. In fact, some studies suggest that people with uremic pruritus have a higher mortality (death) rate than those with CKD or ESKD who don’t have it. Experts think a lack of quality sleep could contribute to the increased rate.
There are no specific steps you can take to prevent itching associated with kidney disease. But if you find certain things make it worse — like dryness, temperature or stress — you might be able to avoid flare-ups. Depending on your triggers, some strategies might include:
Let your healthcare provider know if you’re experiencing itching and how severe it is. There might be changes to your treatment they can make or other ways to manage it so it doesn’t impact your quality of life.
A note from Cleveland Clinic
Itching can be mildly bothersome or completely debilitating. If you have chronic or end-stage kidney disease and itching is affecting your life, talk to your healthcare provider. Make sure they know its impact on you. They can work with you to come up with treatments to get you relief.
Last reviewed by a Cleveland Clinic medical professional on 05/31/2023.
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