Effect of oral granisetron in uremic pruritus

Background : Renal itch is a relatively common and distressing problem for patients with chronic renal failure. Granisetron, is a potent and selective inhibitor of 5-HT3 receptors. There have been some studies about the effect of ondansetron in uremic pruritus and one case report has recently described relief of renal itch with granisetron.
Aims : To evaluate the effect of Granisetron on uremic pruritus in Continuous Ambulatory Peritoneal Dialysis (CAPD) and Hemodialysis (HD) patients.
Methods: To study the prevalence of uremic pruritus, patients on CAPD and HD were asked to complete a pruritus questionnaire.Their replies were scored based on numerical scales. Pruritus was graded, according to the total points for each patient, as mild, moderate or severe. Fourteen patients with moderate to severe pruritus were enrolled in the trial. During treatment, patients received granisetron (1 mg tablet twice a day P.O), for a period of 1 month. They were asked to score the severity of pruritus twice a day.
Results : Seventy seven percent of the patients responded to the treatment and at 1^st , 2^nd and 4^th week the mean values of the pruritus scores were 23, 16 and 8 points respectively. Before starting treatment the score was 31 points ( P =0.03). Weekly clinical and laboratory examination showed no important side effects.
Conclusion : Granisetron might be an effective, safe and well tolerated drug for the treatment of uremic pruritus.

Keywords
Continuous Ambulatory Peritoneal Dialysis, Granisetron, Hemodialysis, Uremic pruritus