Efficacy of narrowband ultraviolet phototherapy on renal pruritus.

ABSTRACT

AIMS AND OBJECTIVES: To test the efficacy of narrowband ultraviolet B phototherapy in reducing renal pruritus. BACKGROUND: Renal pruritus is a disabling symptom affecting approximately 50% of patients undergoing maintenance haemodialysis. Managing refractory pruritus can be a great challenge for healthcare providers and patients as well. For patients who do not respond to conventional treatments, ultraviolet B phototherapy is considered the treatment of choice. Few investigators, however, have studied the efficacy of narrowband ultraviolet B phototherapy in this condition. DESIGN: The study was based on a quasi-experimental design with repeated measures. METHODS: A convenience sample of 42 haemodialysis patients with pruritus was recruited from haemodialysis units of a general hospital in Taipei, Taiwan. Two groups were created according to the dates of haemodialysis. The intervention participants received narrowband ultraviolet B phototherapy three times a week for two weeks. The control participants were maintained on their prior pruritus treatment. The pruritus intensity was measured with a numerical rating scale at baseline and on alternating days for seven times. Data were collected during the year 2008. RESULTS: The generalised estimating equation showed statistically significant group-by-time interactions in pruritus intensity. Using the control group as the reference group and baseline as the reference time, the intervention group had significantly lower pruritus intensity than the control group 3·14 (p < 0·001) at time seven, 1·71 (p < 0·001) at time six and 1·24 at time five (p < 0·001). The group-by-time interactions were statistically significant after four sessions of narrowband-UVB irradiation. CONCLUSION: The study findings support the efficacy of narrowband ultraviolet B phototherapy in alleviating renal pruritus. RELEVANCE TO CLINICAL PRACTICE Clinicians may consider prescribing phototherapy for haemodialysis patients who have intractable renal pruritus and do not respond to conventional treatments.