Persistent
pruritus is one of the most common symptoms in
hemodialysis patients. The cause of
pruritus is not known, and conventional treatment for
pruritus is rarely helpful. Some authors thought that release of
histamine from increased mast cells in uremic patients was the cause of
pruritus. On the other hand, there have been a number of reports suggesting that uremic patients are
zinc deficient. In vitro as well as in vivo studies have demonstrated that
zinc has an inhibitory effect on various functions of some cells, such as histamine release from mast cells. In this study, we examined the serum
zinc and
histamine levels in 19
hemodialysis patients with persistent
pruritus and the effect of
zinc supplementation on the
pruritus. In patients with
pruritus, the serum
zinc level decreased and serum
histamine level increased, showing a negative correlation between them. Oral
zinc sulfate, 445 mg daily for two months, relieved
pruritus subjectively in 53% of the patients.
After treatment, serum
histamine levels decreased significantly, as well as serum
zinc levels increased significantly. These findings suggest that
zinc deficiency participates in increased
histamine levels in dialysis patients, and subsequently in the development of uremic
pruritus.