Chronic Kidney Disease-Associated Pruritus

A debilitating condition affecting 50-60% of dialysis patients, characterized by severe generalized itching not originating from skin lesions. Associated with impaired quality of life, sleep disturbance, and depression. Also known as uremic pruritus.

Quick Answer

What it is

A debilitating condition affecting 50-60% of dialysis patients, characterized by severe generalized itching not originating from skin lesions. Associated with impaired quality of life, sleep disturbance, and depression.

Key findings

  • Grade A: Itch Intensity Reduction (Difelikefalin (Korsuva))
  • Grade A: Itch-Related Quality of Life (Difelikefalin (Korsuva))
  • Grade A: Sleep Improvement (Difelikefalin (Korsuva))

Safety

No specific caution or interaction language was detected in the current summary/outcome notes.

ℹ️ Quick Facts

Quick Facts: Chronic Kidney Disease-Associated Pruritus

  • Supplements Studied:1
1 supps · 3 outcomes

Detailed Outcomes

A
Itch Intensity Reduction
KALM-1/2 Phase 3: 51% achieved ≥3-point WI-NRS reduction vs 28% placebo (P<0.001). Mean 4.2-point decrease vs 2.5-point placebo. Effects sustained up to 64 weeks. First FDA-approved treatment for CKD-aP.
largeImproves
A
Itch-Related Quality of Life
Pooled analysis: 55.5% achieved ≥15-point Skindex-10 improvement vs 40.5% placebo (P<0.001). 52.1% achieved ≥5-point 5-D Itch improvement vs 42.3% placebo (P=0.01). Sustained benefits to 64 weeks.
largeImproves
A
Sleep Improvement
Significant improvement in itch-related sleep disturbance. Reduced nighttime awakening due to pruritus. Benefits consistent across demographic and disease characteristic subgroups.
largeImproves

Research Citations (42)

The efficacy and safety of intravenous difelikefalin for the treatment of pruritus in patients undergoing hemodialysis: a systematic review and meta-analysis of randomized controlled trials.
(2026)
PMID: 41481512
Systemic Inflammatory Markers Correlate with Chronic Kidney Disease-Associated Pruritus and Response to Treatment.
(2026)
PMID: 40409676
Cost-utility analysis of difelikefalin for the treatment of moderate to severe Chronic Kidney Disease associated-Pruritus (CKD-aP) in adult patients receiving haemodialysis in Spain.
(2025)
PMID: 40411773
The efficacy and safety of kappa opioid receptor (KOR) agonists in patients with uraemic pruritus: a systematic review and network meta-analysis.
(2025)
PMID: 40567495
Difelikefalin for CKD-aP: real world evidence of efficacy and safety in Italian patients.
(2025)
PMID: 40989995
Real-world safety of difelikefalin for chronic kidney disease-associated pruritus: initial insights from a European managed access programme.
(2025)
PMID: 41133182
Real-world effectiveness and tolerability of difelikefalin over 12 months for hemodialysis-associated pruritus.
(2025)
PMID: 41436718
Nanoliposome-sericin hydrogel microneedle patches effectively alleviate inflammation and scavenge ROS for the treatment of CKD-aP.
(2025)
PMID: 40487159
Anti-inflammatory and renoprotective effects of difelikefalin, a kappa opioid receptor agonist, in a rat model of renal ischemia-reperfusion-induced acute kidney injury.
(2025)
PMID: 40596915
Long-term efficacy of difelikefalin in hemodialysis patients with pruritus: KALM-1 and KALM-2 extension studies
(2024)
PMID: 38116287