الفهرس 
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Abstract
Chronic itch is defined as itch lasting more than 6 weeks. The
prevalence of chronic pruritus in the general population has been
reported to range from 8.4 to 13.9 %.
Chronic Pruritus may involve the entire skin (generalized
pruritus) or only particular areas, such as the scalp, upper back, arms,
or groin (localized pruritus).
Pruritus is one of the most common complaints associated with
ESRD (End stage renal disease). Pruritus is present in anywhere from
40% to 90% of patients with ESRD, which reflects its subjective
nature.
Uremic pruritus (UP) is a common and disturbing problem in
hemodialysis patients. Although its pathogenesis is not completely
understood, it is thought to be multifactorial. Many hypotheses have
been proposed regarding the development of UP. Recent hypotheses
suggest that changes in the immune and opioid systems are to blame
for UP.
There are several recommended non pharmacologic and
pharmacologic treatments available, such as gentle soaps and
moisturizers, topical ointments and gabapentin.
Substance P (SP) was the first identified mammalian
neuropeptide, which was discovered in 1931 by Von Euler and
Gaddum as a vasodilator substance in crude tissue extracts from
equine brain and intestine. The acid alcohol extracted powder was at
the time referred to as SP.Summary
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When skin is stressed, SP is released from sensory nerves
present in the upper dermal nerve plexus; these sensory nerves also
innervate the epidermis. The released SP initiates skin inflammation
via induction of vasodilation, plasma extravasation, and accumulation
of immune factors, as well as uncomfortable skin sensations such as
numbness, itching, sensitivity, and tingling.
Very few studies have been published on the role of
neuropeptides in chronic renal disease. Substance P, one of the
neuropeptides, might be one of the main mediators of uremic pruritus.
Histamine, which is released from mast cells in response to substance
P, has been implicated in UP.
The aim of this study is to evaluate the relation between serum
Substance P level and Pruritus in renal patients.
The current study was conducted according to sample size
calculation on 44 renal pruritus patients & 30 sex and age matched
healthy individuals as a control group and were selected by random
sample. The studied subjects were collected from the inpatients at
Menoufia University Hospitals.
All patients were subjected to full history taking including (age,
frequency of itching, time of itching and duration of chronic kidney
disease).
The results of our study revealed that there were statistically
significant difference between patients and control group regarding to
serum substance p level and serum C-reactive protein level.
In this study there was no statistically significant difference
between patients and control group regarding age and sex.
Also, our study revealed that renal pruritus worse duringSummary
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nighttime than during daytime and that the duration of chronic kidney
disease correlated positively with the frequency of itching.