The Effect of Omega-3 Fatty Acids versus Gabapentin in Uremic Pruritus in Hemodialysis Patients. Randomized Controlled, Cross-Over Clinical Trial

Abstract Introduction One of the most annoying, common, and even incapacitating issues for people with chronic kidney disease (CKD) is uremic pruritus. However, the lack of essential fatty acids is a significant area of etiological concern in connection to uremic pruritus. It appears that giving ESRD patients more necessary fatty acids and their derivatives may have a number of good effects on their physiological characteristics and cellular membrane structure. Omega-3 fatty acids have anti-inflammatory benefits for many inflammatory disorders. Abundance of Omega-3 fatty acids has been proven to be useful in the reduction of pruritus. So, we aimed in this study to evaluate the effect of Omega – 3 fatty acids versus Gabapentin in uremic pruritus in hemodialysis (HD) patients. Methods In a randomized controlled trial, we enrolled 50 prevalent HD patients recruited from the HD unit at Ain Shams University Hospital. Patients were randomly assigned to two arms: Group A: Included 25 patients who received Omega-3 added to the traditional treatment (Calcium, erythropoietin stimulating agent). Patients received treatment for four weeks, then after washout period (6 weeks) on traditional treatment only then Gabapentin was given. Group B: Included 25 patients who received Gabapentin added to the traditional treatment (Calcium, erythropoietin stimulating agent). Patients received treatment for four weeks then after washout period (6 weeks) on traditional treatment only then Omega-3 was given. Results PGE2 was significantly reduced among patients treated with Omega-3 compared to Gabapentin. 5-D itch scale was significantly reduced among all patients after treatment with Omega-3 Conclusion We have demonstrated that Omega-3 fatty acids are not less effective than Gabapentin in decreasing uremic pruritus. It seems that Omega-3 fatty acids could be used as an efficient drug for the treatment of pruritus in uremic patients.