Efficacy and Safety of Gabapentin for Uremic Pruritus and Restless Legs Syndrome in Conservatively Managed Patients With Chronic Kidney Disease

Abstract Context Pruritus and restless legs syndrome (RLS) frequently affect patients with chronic kidney disease (CKD) and end-stage kidney disease (ESKD), impacting the quality of life. Gabapentin (1-aminomethyl cyclohexane acetic acid) alleviates these symptoms in hemodialysis (HD) patients, but...

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Bibliographic Details
Published in:Journal of pain and symptom management 2015-04, Vol.49 (4), p.782-789
Main Authors: Cheikh Hassan, Hicham I., MBBS, Brennan, Frank, MBBS, Collett, Gemma, BHSc, Josland, Elizabeth A., RN, DipNursing(NZ), MPH, Brown, Mark A., MBBS, MD
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Amines - adverse effects
Amines - therapeutic use
Analgesics - adverse effects
Analgesics - therapeutic use
Anesthesia & Perioperative Care
conservative management
Cyclohexanecarboxylic Acids - adverse effects
Cyclohexanecarboxylic Acids - therapeutic use
dialysis
end-stage kidney disease
Female
Gabapentin
gamma-Aminobutyric Acid - adverse effects
gamma-Aminobutyric Acid - therapeutic use
Humans
Male
Pain Medicine
pruritus
Pruritus - drug therapy
Pruritus - physiopathology
Renal Insufficiency, Chronic - physiopathology
restless legs syndrome
Restless Legs Syndrome - drug therapy
Restless Legs Syndrome - physiopathology
Retrospective Studies
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Summary:Abstract Context Pruritus and restless legs syndrome (RLS) frequently affect patients with chronic kidney disease (CKD) and end-stage kidney disease (ESKD), impacting the quality of life. Gabapentin (1-aminomethyl cyclohexane acetic acid) alleviates these symptoms in hemodialysis (HD) patients, but data are lacking for patients on the conservative pathway. Objectives To determine the safety and effectiveness of gabapentin for pruritus or RLS in conservatively managed patients ( n  = 34) with CKD and ESKD. Methods This was a single-center retrospective cohort study. We compared dosing and side effects in 34 CKD/ESKD patients with similar patients receiving HD ( n  = 15). Results Forty-four percent of conservatively managed patients complained of RLS and/or pruritus; 18% were excluded for a nonuremic cause of symptom. Thirty-four patients were included in the final analysis. The most common starting daily dose of gabapentin was the equivalent of 50 mg (44.1%) or 100 mg (38.2%) daily, with the median daily dose of 100 mg (range 39–455 mg). Side effects occurred in 47% of patients, with 17% discontinuing gabapentin. Gabapentin reduced symptoms of pruritus ( P  
ISSN:0885-3924
1873-6513
DOI:10.1016/j.jpainsymman.2014.08.010