Acupuncture for Treating Uremic Pruritus in Patients with End-Stage Renal Disease: A Systematic Review

Abstract Uremic pruritus (UP) is a common and bothersome symptom in end-stage renal disease (ESRD) that does not always respond to conventional care. Acupuncture is frequently used for the treatment of a wide range of conditions, but its effects on UP in ESRD patients are unclear. The objective of t...

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Bibliographic Details
Published in:Journal of pain and symptom management 2010-07, Vol.40 (1), p.117-125
Main Authors: Kim, Kun Hyung, OMD, MS, Lee, Myeong Soo, PhD, Choi, Sun-Mi, OMD, PhD, Ernst, Edzard, MD, PhD, FRCP, FRCPEd
Format: Article
Language:English
Subjects:
Acupuncture
Acupuncture Therapy - methods
Anesthesia & Perioperative Care
Bias
Biological and medical sciences
Electroacupuncture - methods
end-stage renal disease
Humans
itching
Kidney diseases
Kidney Failure, Chronic - complications
Medical sciences
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
Pain Medicine
Pharmacology. Drug treatments
Pruritus - etiology
Pruritus - therapy
Randomized controlled trials
Randomized Controlled Trials as Topic
Renal failure
Symptoms
systematic review
Uremia - complications
Uremia - etiology
uremic pruritus
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Summary:Abstract Uremic pruritus (UP) is a common and bothersome symptom in end-stage renal disease (ESRD) that does not always respond to conventional care. Acupuncture is frequently used for the treatment of a wide range of conditions, but its effects on UP in ESRD patients are unclear. The objective of this review was to evaluate the effectiveness of acupuncture for UP in patients with ESRD. We searched 16 electronic databases from their inception to November 2009. All prospective clinical studies of needle acupuncture for UP in hemodialysis patients with ESRD were included regardless of their design. Risk of bias of the included studies was assessed using the Cochrane criteria. Three randomized controlled trials and three uncontrolled observational studies were included. All of the included trials reported beneficial effects of acupuncture. However, most of the studies showed high risk of bias, which leaves their reports unconvincing. The current evidence is insufficient to show that acupuncture is an effective treatment for UP in patients with ESRD because of suboptimal quality and lack of methodological rigor of included studies. Future trials should overcome the limitations of the currently available evidence.
ISSN:0885-3924
1873-6513
DOI:10.1016/j.jpainsymman.2009.11.325