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Clinical Practice: Original Paper

Total Calcium and Albumin Are Decreased in the Deeper Epidermis of Patients with Chronic Kidney Disease-Associated Pruritus

Momose A.a · Shiraiwa Y.a · Narita S.b · Kusumi T.c · Goto S.d · Sera K.e

Author affiliations

aDepartment of Urology, Jusendo General Hospital, and bDepartment of Urology, Odate Municipital Hospital, Koriyama, cDepartment of Pathology, Aomori Municipital Hospital, Aomori, dTakizawa Institute, Japan Radioisotope Association, and eTakizawa Research Center, Iwate Medical University, Morioka, Japan

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Nephron 2017;136:103-110

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Article / Publication Details

First-Page Preview
Abstract of Clinical Practice: Original Paper

Received: June 20, 2016
Accepted: January 25, 2017
Published online: February 10, 2017
Issue release date: June 2017

Number of Print Pages: 8
Number of Figures: 2
Number of Tables: 4

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: https://www.karger.com/NEF

Abstract

Background/Aims: In our earlier studies, we reported high concentrations of intra- and extracellular calcium ions (Ca2+) in the deeper epidermis of patients with chronic kidney disease (CKD) and associated pruritus. To determine the cause of this phenomenon, we measured total calcium (TCa) concentrations in the deeper epidermis and performed immunostaining of epidermal albumin, which binds to Ca2+. Methods: This study included 45 patients with CKD-stage 5, which was defined as severely reduced kidney function (i.e., estimated glomerular filtration rate less than 15 mL/min or on dialysis). Subjects were divided into the pruritus group, consisting of patients with mild, moderate, or severe uremic pruritus, and the non-pruritus group, consisting of patients with no or slight pruritus. The particle-induced X-ray emission method was used to measure elements including TCa. Furthermore, we have immunostained epidermal albumin using anti-albumin antibodies and compared the results in the pruritus and non-pruritus groups. Results: The TCa concentration in the spinous layer of patients with CKD with CKD-associated pruritus was lower than in patients with CKD without pruritus (median [range], 395 [235-1,063] vs. 476 [342-1,243] μg/g). The intensity of epidermal albumin expression in the spinous layer was weaker in patients with CKD with CKD-associated pruritus than in those without. Conclusion: Patients with CKD with CKD-associated pruritus demonstrated higher Ca2+ concentrations but lower TCa concentrations than patients without CKD-associated pruritus. This could be in part due to low concentrations of epidermal albumin, which binds to Ca2+, in those with CKD-associated pruritus. These results clarify the pathophysiology of CKD-associated pruritus, providing a valuable foundation for the future development of treatments for this condition.

© 2017 S. Karger AG, Basel


References

  1. Kimata N, Fuller DS, Saito A, Akizawa T, Fukuhara S, Pisoni RL, Robinson BM, Akiba T: Pruritus in hemodialysis patients: results from the Japanese Dialysis Outcomes and Practice Patterns Study (JDOPPS). Hemodial Int 2014;18:657-667.
  2. Hampers CL, Katz AI, Wilson RE, Merrill JP: Disappearance of “uremic” itching after subtotal parathyroidectomy. N Engl J Med 1968;279:695-697.
  3. Momose A, Kudo S, Sato M, Saito H, Nagai K, Katabira Y, Funyu T: Calcium ions are abnormally distributed in the skin of haemodialysis patients with uraemic pruritus. Nephrol Dial Transplant 2004;19:2061-2066.
  4. Wiley JW, Moises HC, Gross RA, MacDonald RL: Dynorphin A-mediated reduction in multiple calcium currents involves a G(o) alpha-subtype G protein in rat primary afferent neurons. J Neurophysiol 1997;77:1338-1348.
  5. Fallahzadeh MK, Roozbeh J, Geramizadeh B, Namazi MR: Interleukin-2 serum levels are elevated in patients with uremic pruritus: a novel finding with practical implications. Nephrol Dial Transplant 2011;26:3338-3344.
  6. Ko MJ, Peng YS, Chen HY, Hsu SP, Pai MF, Yang JY, Wen SY, Jee SH, Wu HY, Chiu HC: Interleukin-31 is associated with uremic pruritus in patients receiving hemodialysis. J Am Acad Dermatol 2014;71:1151-1159.
  7. Makhlough A, Ala S, Haj-Heydari Z, Kashi Z, Bari A: Topical capsaicin therapy for uremic pruritus in patients on hemodialysis. Iran J Kidney Dis 2010;4:137-140.
  8. Akiyama A, Tominaga M, Takamori K, Carstens MI, Carstens E: Roles of glutamate, substance P, and gastrin-releasing peptide as spinal neurotransmitters of histaminergic and nonhistaminergic itch. Pain 2014;155:80-92.
  9. Mishra SK, Hoon MA: The cells and circuitry for itch responses in mice. Science 2013;340:968-971.
  10. Forslind B, Werner-Linde Y, lindberg M, Pallon J: Elemental analysis mirrors epidermal differentiation. Acta Derm Venereol 1999;79:12-17.
  11. Nicholson JP, Wolmarans MR, Park GR: The role of albumin in critical illness. Br J Anaesth 2000;85:599-610.
  12. Pisoni RL, Wikstrom B, Elder SJ, Akizawa T, Asano Y, Keen ML, Saran R, Mendelssohn DC, Young EW, Port FK: Pruritus in haemodialysis patients: international results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant 2006;21:3495-3505.
  13. Stolic R, Trajkovic G, Peric V, Jovanovic A, Lazarevic T, Subaric-Gorgieva G: Parameters of clinical and biohumoral status of pruritus in patients on chronic haemodialysis. Med Pregl 2007;60;101-103.
  14. Sera K, Yanagisawa T, Tsunoda H, Futatsugawa S, Hatakeyama S, Saitoh Y, Suzuki S, Orihara H: Bio-PIXE at the Takizawa facility. (Bio-PIXE with a baby cyclotron). Int'l J PIXE 1992;2:325-330.
  15. Sera K, Itoh J, Goto S, Saitoh Y, Fujimura A, Nosaka Y, Noda Y, Nishizuka S, Wakabayashi G: Quantitative analysis of very small quantity of organs taken from patients and experimental animals. Int'l J PIXE 2008;18:111-122.
  16. Sera K, Futatsugawa S: Spectrum analysis taking account of the tail, escape functions and sub-lines. (SAPIX version 4). Int'l J PIXE 2000;10:101-114.
  17. Menon GK, Elias PM, Feingold KR: Integrity of the permeability barrier is crucial for maintenance of the epidermal calcium gradient. Br J Dermatol 1994;130:139-147.
  18. Clapham DE: Calcium signaling. Cell 2007;131:1047-1058.
  19. Hung KY, Shyu RS, Tsai TJ, Chen WY: Viral hepatitis infection should be considered for evaluating uremic pruritus in continuous ambulatory peritoneal dialysis patients. Blood Purif 1998;16:147-153.
  20. Chen HY, Chiu YL, Hsu SP, Pai MF, Lai CF, Yang JY, Peng YS, Tsai TJ, Wu KD: Elevated C-reactive protein level in hemodialysis patients with moderate/severe uremic pruritus. QJM 2010;103:837-846.
  21. Kyriazis J, Glotsos J: Dialysate calcium concentration of ≤1.25 mmol/l: is it effective in suppressing uremic pruritus? Nephron 2000;84:85-86.
  22. Chou FF, Ho JC, Huang SC, Sheen-Chen SM: A study on pruritus after parathyroidectomy for secondary hyperparathyroidism. J Am Coll Surg 2000;190:65-70.
  23. Fusao M, Munaretto G, Spinello M, Gallieni M: Regression of uraemic pruritus by cyclosporin treatment in a haemodialysis patient. Nephrol Dial Transplant 2004;19:1338-1339.
  24. Manenti L, Vaglio A, Costantino E, Danisi D, Oliva B, Pini S, Prati E, Testori A: Gabapentin in the treatment of uremic itch. J Nephrol 2005;18:86-91.
  25. Jung KE, Woo YR, Lee JS, Shin JH, Jeong JU, Koo DW, Bang KT: Effect of topical vitamin D on chronic kidney disease-associated pruritus. J Dermatol 2015;42:800-803.
  26. Tang M, Wu G, Wang Z, Yang N, Shi H, He Q, Zhu C, Yang Y, Yu G, Wang C, Yuan X, Liu Q, Guan Y, Dong X, Tang Z: Voltage-gated potassium channels involved in regulation of physiological function in MrgprA3-specific itch neurons. Brain Res 2016;1636:161-171.
  27. Wiegand C, Hipler UC, Boldt S, Strehle J, Wollina U: Skin-protective effects of a zinc oxide-functionalized textile and its relevance for atopic dermatitis. Clin Cosmet Investig Dermatol 2013;6:115-121.
  28. Panahi Y, Davoudi SM, Beiraghdar F, Amiri M, Saadat A, Marzony ET, Naghizadeh MM, Sahebkar A: Serum levels of interleukins 2, 4, 6, and 10 in veterans with chronic sulfer mustard-induced pruritus. Skinmed 2013;11:205-209.
  29. Melon NC, Elias RM, Castro MC, Romao JE Jr, Abensur H: Pruritus in hemodialysis patients: the problem remains. Hemodial Int 2009;13:38-42.
  30. Ascher P, Nowak L: The role of divalent cations in the N-methyl-D-aspartate responses of mouse central neurones in culture. J Physiol 1988:399; 247-266.

Article / Publication Details

First-Page Preview
Abstract of Clinical Practice: Original Paper

Received: June 20, 2016
Accepted: January 25, 2017
Published online: February 10, 2017
Issue release date: June 2017

Number of Print Pages: 8
Number of Figures: 2
Number of Tables: 4

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: https://www.karger.com/NEF


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