Characteristics of pruritus in children on peritoneal dialysis.

BACKGROUND/AIMS: The aim of this study was to evaluate the characteristics of pruritus in pediatric patients undergoing peritoneal dialysis. PATIENTS AND METHODS: Twenty-seven patients (16 females, 11 males), aged between 5 and 18 years, were evaluated for the presence, intensity, onset, activation time, duration, characteristics, localization and increasing factors for pruritus. The intensity of pruritus was scored using a visual analog scale. Patients were grouped according to the existence of pruritus and other clinical and laboratory parameters (dialysis duration, dialysis adequacy, hemoglobin, blood urea nitrogen, creatinine, Ca, P, albumin, bicarbonate, parathyroid hormone (PTH), C-reactive protein (CRP)) were compared between the 2 groups. RESULTS: The mean age of patients was 11.85 +/- 4.4 years. There were 21 patients (77.7%) without pruritus and 6 patients with pruritus (22.2%). Serum P, PTH, CRP levels and CaxP product were significantly higher in patients with pruritus compared to patients without pruritus (p = 0.027, p = 0.03, p < 0.026, p = 0.031, respectively). In a stepwise logistic regression model, P (p = 0.01), CaxP product (p = 0.09), PTH (p = 0.03) and CRP (p = 0.02) were independently associated with pruritus. CONCLUSION: Our study indicates that pruritus remains a common but not troublesome symptom in children on peritoneal dialysis. Higher serum P, CaxP product, PTH and CRP concentrations appear to be important factors associated with uremic pruritus in this group.

Evaluation of nailfold capillaries in familial Mediterranean fever patients.

Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by recurrent inflammatory febrile attacks, abdominal, chest or joint pain, myalgia, and erysipelas-like skin lesions. Several types of vasculitis are associated with FMF such as polyarteritis nodosa and Henoch-Schönlein purpura. We aimed to determine microvascular abnormalities in FMF patients via nailfold capillaroscopy using a dermoscope. Thirty-one FMF patients were assessed; capillary enlargement, tortuosity, avascular areas and microhemmoraghes were investigated. Capillary enlargement was found in five patients and microhemorrhages in one patient. Our study supports that nailfold capillary abnormalities, which are nonspecific, can be seen in FMF patients, but more studies are needed to clarify the importance of these findings.