Abstract
The present study was conducted to elucidate the mechanism of the effects of fat emulsion on pruritus cutanea in chronic hemodialysis (HD) patients.
Fasting fatty acid fractions of serum total lipids in 3 end stage renal disease (ESRD) patients and 8 HD patients were measured. All fatty acid components were normal in ESRD patients, but low in HD patients. This tendency was remarkable for linoleic acid: the referential normal range was 4.53-8.20μmol/l, while ESRD patients registered 4.39±1.17μmol/l and HD patients showed 2.76±0.30μmol/l. When HD patients were divided into two groups based on those that experienced itching and those that did not, a comparison revealed no significant difference in fatty acid concentration between the two groups. Fat emulsion (Intralipos®20% 200ml) was administered intravenously to all HD patients during hemodialysis twice a week for four weeks; a total of eight times, and the degree of itchiness and fasting fatty acid fractions of total lipids were evaluated prior to the first injection, at the end of injection, and at four weeks after the final injection. An alleviation of itching was observed in all patients, and this effect was sustained even four weeks after the final injection. No significant change, however, was observed in serum fatty acid fractions.
It is accordingly concluded that the low levels of serum fatty acid fractions do not play an important role in the development of pruritus cutanea, and that the fat emulsion induced alleviation of itching is not associated with alterations of serum fatty acid fractions in chronic hemodialysis patients.
