COMPARING THE EFFICACY AND SAFTEY OF PREGABALIN VS GABAPENTIN IN UREMIC PRURITUS IN PATIENTS OF CHRONIC KIDNEY INJURY UNDERGOING HEMODIALYSIS
Abstract
Background: World has been facing an epidemic of non-communicable diseases including heart, metabolic and renal diseases. renal diseases have been commonly diagnosed and managed in low- and middle-income countries. Objective was to compare efficacy and safety of Pregabalin and Gabapentin in uremic pruritus among patients of chronic kidney injury undergoing haemodialysis. It was a comparative cross-sectional study, conducted at the Department of nephrology Abbottabad International Medical Institute. February 2021 to January 2022. Methods: Total of 90 cases were included in the study, which were diagnosed as chronic kidney disease stage 5 undergoing haemodialysis and presented with pruritus. Pruritus was gauged on numeric rating scale and patients score of more than 6 were included. Patients were randomly divided into two groups via lottery method. Group A received Pregabalin while group B received Gabapentin. Efficacy and safety were assessed in both groups at the end of six months. Results: Out of 90 dialysis dependent chronic kidney disease patients with significant pruritus included in the study, 61 (52.7%) patients were males and 29 (46.3%) were females. At the end of 6 weeks, we found out that 35 (38.9%) had no pruritus, 25 (27.8%) had mild, 19 (21.1%) had moderate while 11 (12.2%) had severe pruritus. After applying the chi-square test we found that Pregablin was statistically significantly more efficacious then Gabapentin (p-value-0.026). Sedation, nausea and blurred vision were found more in patients who took Pregabalin (p-value<0.001). Conclusion: Pregablin emerged out to be more efficacious with regards to reducing pruritus of the two medications compared in our study population while patients who took Gabapentin experience significantly a smaller number of side effects as compared to patients who were given Pregabalin.References
Fraser SD, Blakeman T. Chronic kidney disease: identification and management in primary care. Pragmat Obs Res 2016;7:21–32.
O'Callaghan-Gordo C, Shivashankar R, Anand S, Ghosh S, Glaser J, Gupta R, et al. Prevalence of and risk factors for chronic kidney disease of unknown aetiology in India: secondary data analysis of three population-based cross-sectional studies. BMJ Open 2019;9(3):e023353.
Ruwanpathirana T, Senanayake S, Gunawardana N, Munasinghe A, Ginige S, Gamage D, et al. Prevalence and risk factors for impaired kidney function in the district of Anuradhapura, Sri Lanka: a cross-sectional population-representative survey in those at risk of chronic kidney disease of unknown aetiology. BMC Public Health 2019;19(1):763.
Grill AK, Brimble S. Approach to the detection and management of chronic kidney disease: What primary care providers need to know. Can Fam Physician 2018;64(10):728–35.
Aoun M, Karam R, Sleilaty G, Antoun L, Ammar W. Iron deficiency across chronic kidney disease stages: Is there a reverse gender pattern? PLoS One 2018;13(1):e0191541.
Martin CE, Clotet-Freixas S, Farragher JF, Hundemer GL. Have We Just Scratched the Surface? A Narrative Review of Uremic Pruritus in 2020. Can J Kidney Health Dis 2020;7:2054358120954024.
Swarna SS, Aziz K, Zubair T, Qadir N, Khan M. Pruritus Associated With Chronic Kidney Disease: A Comprehensive Literature Review. Cureus 2019;11(7):e5256.
Haber R, Bachour J, Salloum A, Maacaron T, Khoury F, Habr L, et al. Comparison of gabapentin and doxepin in the management of uremic pruritus: A randomized crossover clinical trial. Dermatol Ther 2020;33(6):e14522.
Ravindran A, Kunnath RP, Sunny A, Vimal B. Comparison of Safety and Efficacy of Pregabalin versus Gabapentin for the treatment of Uremic Pruritus in Patients with Chronic Kidney Disease on Maintenance Haemodialysis. Indian J Palliat Care 2020;26(3):281–6.
Rehman IU, Munib S, Ramadas A, Khan TM. Prevalence of chronic kidney disease-associated pruritus, and association with sleep quality among hemodialysis patients in Pakistan. PLoS One 2018;13(11):e0207758.
Hu X, Sang Y, Yang M, Chen X, Tang W. Prevalence of chronic kidney disease-associated pruritus among adult dialysis patients: A meta-analysis of cross-sectional studies. Medicine (Baltimore) 2018;97(21):e10633.
Kramer H, Berns JS, Nally J, Choi MJ, Rocco MV. A decade after the KDOQI CKD guidelines: impact on NKF-KDOQI. Am J Kidney Dis 2012;60(5):694–6.
Verweyen E, Ständer S, Kreitz K, Höben I, Osada N, Gernart M, et al. Validation of a comprehensive set of pruritus assessment instruments:the chronic pruritus tools questionnaire PRURITOOLS. Acta Derm Venereol 2019;99(7):657–63.
Yosipovitch G, Reaney M, Mastey V, Eckert L, Abbé A, Nelson L, et al. Peak Pruritus Numerical Rating Scale: psychometric validation and responder definition for assessing itch in moderate-to-severe atopic dermatitis. Br J Dermatol 2019;181(4):761–9.
Rayner H, Baharani J, Smith S, Suresh V, Dasgupta I. Uraemic pruritus: relief of itching by gabapentin and pregabalin. Nephron Clin Pract 2012;122(3-4):75–9.
Solak Y, Biyik Z, Atalay H, Gaipov A, Guney F, Turk S, et al. Pregabalin versus gabapentin in the treatment of neuropathic pruritus in maintenance haemodialysis patients: a prospective, crossover study. Nephrology (Carlton) 2012;17(8):710–7.
Ishida JH, McCulloch CE, Steinman MA, Grimes BA, Johansen KL. Gabapentin and Pregabalin Use and Association with Adverse Outcomes among Hemodialysis Patients. J Am Soc Nephrol 2018;29(7):1970–8.
Lau T, Leung S, Lau W. Gabapentin for uremic pruritus in hemodialysis patients: a qualitative systematic review. Can J Kidney Health Dis 2016;3:14.
Downloads
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.