Abstract
To determine the effect of lactulose as an antipruritic agent in chronic dialysis patients with severe pruritus, lactulose was administered to 15 patients (10 hemodialysis, 5 CAPD). Four weeks after administration of 16g of lactulose at night, itching severity score decreased from 2.87±0.17 to 1.87±0.22 (p<0.05). Over the following four weeks, the dose of lactulose was increased to 32g (16g at morning and night). The itching score further decreased to 1.60±0.25 (p<0.05). In biochemical findings, there were no remarkable change in the serum level of BUN, calcium, phosphate, total cholesterol, triglyceride, GOT, or GPT. Only creatinine decreased from 12.2±0.5mg/dl to 11.4±0.5mg/dl (p<0.05) in the eight weeks period. We further examined the serum levels of β2-microglobuline, methylguanidine, guanidinosuccinic acid, indoxyl-sulfate and para-cresol as uremic toxins and pentosidine, an advanced glycosilation end product. All serum concentrations of uremic toxins and pentosidine, except β2-microglobuline, decreased with the administration of lactulose (p<0.05). These results suggest that lactulose may be useful for chronic dialysis patients as an antipruritic agent.
