THE EFFECT OF AZELASTIN HYDROCHLORIDE ON PRURITUS AND LEUKOTRIENE B4 IN HEMODIALYSIS-PATIENTS

Pruritus is a very common complication in chronic hemodialysis (HD) pa tients, however the exact mechanism for this affliction is still not k nown. Anti-histaminics usually failed to alleviate uremic pruritus. In others, an anti-allergic drug, which inhibits the release of chemical mediators, such as leukotrienes or histamine from mast cells, was rep orted to be effective. We evaluated the values of leukotriene B4 and i nterleukin 6 in HD patients with pruritus and the effect of an anti-al lergic drug on these factors. Leukotriene B4, interleukin-6, C3a, C5a, the number of eosinophil and IgE at 0, 15 and 180 minutes after the s tart of regular HD in 11 HD patients suffering from pruritus and as we ll as in 11 HD patients without pruritus were examined. These HD patie nts in both groups showed significantly higher (p<0.001) values of leu kotriene B4 and C3a compared to healthy non-KD subjects. There was no difference in the leukotriene B4, interleukin-6, IgE, C3a and C5a leve ls between the patients with and without pruritus. Two mg/day of azela stin hydrochloride, an anti-allergic drug was orally given to the prur itus group for 3 weeks. In 5 of 11 patients, the pruritus symptoms dis appeared, while in 4 of 11 they improved. Independent of the effect of the drug on pruritus, leukotriene B4 levers significantly decreased c ompared with those before the administration of this drug in the pruri tus group (p<0.01). Interleukin 6, C3a, C5a and the number of eosinoph ils demonstrated no significant change. In conclusion, although azelas tin hydrochloride was effective in treating pruritus and also suppress ed leukotriene B4 levels in hemodialysis patients, the high leukotrien e B4 activity itself did not seem to be related to the development of pruritus in these patients.