Introduction & Objectives
Chronic renal failure (CRF) is a progressive loss in renal function over a period of months or years. It is differentiated from acute kidney disease in that the reduction in kidney function must be present for over 3 months. In Egypt; end stage renal disease (ESRD) is growing by 100% annually; the estimated annual incidence of ESRD is around 74 per million and the total prevalence of patients on dialysis is 264 per million, also there are 90,000 patient die each year because of kidney failure. Uremic pruritus is the most common cutaneous abnormality in patients with CRF. In Egyptian patients with CRF on hemodialysis the prevalence of pruritus was 55%. Nerve growth factor is a neurotropic polypeptide necessary for the survival and growth of some central neurons, as well as sensory afferent and sympathetic neurons. The aim of this study was to investigate the expressions of Nerve growth factor (NGF) and its receptor (TrKA) in CRF patients with pruritus on hemodialysis and correlated the pattern of expressions with an itch score.
Materials & Methods
A case-control study was carried out on 30 patients with CRF and uremic pruritus on hemodialysis who were treated at Sohag Educational Hospital, Sohag, Egypt and 20 healthy control subjects. It was conducted over a period of 2 years from May 2014 to May 2016. Severity of itching was measured by the 5-D itch score. Skin punch biopsy (5 mm) was taken from patients and controls. These samples were treated and processed for immunohistochemical detection of NGF and its receptor (TrKA).
Results
There was significant increase in the expressions of NGF and TrKA in CRF patients with pruritus on hemodialysis compared to the healthy control participants and also there was significant correlation between degree of expressions of NGF and TrKA and 5-D itching score.
Conclusions
According to the results of this study, expressions of NGF and TrKA could be the cause of initiation and maintenance of pruritus in CRF patients with pruritus on dialysis.