Researchers in Benin studied 245 people receiving kidney dialysis treatment to understand why many develop severe itching. They found that about 4 out of 10 dialysis patients experience itching, often for years. The study identified several skin conditions linked to itching, including very dry skin, nail problems, and skin discoloration. Interestingly, patients taking certain diabetes medications had less itching. These findings could help doctors better treat this uncomfortable side effect that affects many dialysis patients’ daily lives.
The Quick Take
- What they studied: Why do people on kidney dialysis develop itchy skin, and what factors make it worse or better?
- Who participated: 245 adults (average age 53) receiving kidney dialysis treatment at three hospitals in Benin, West Africa. Most had been on dialysis for several months or longer.
- Key finding: About 40% of dialysis patients experience itching. The itching is usually mild to moderate and affects large areas of the body. Severe dry skin, longer time on dialysis, and certain types of access tubes (fistulas) made itching more likely. Taking diabetes pills seemed to reduce itching.
- What it means for you: If you’re on dialysis or know someone who is, this research suggests doctors should pay attention to dry skin care and monitor how long patients have been on treatment. Some medications may help reduce itching. Talk to your doctor about your specific situation, as these findings are from one region and may not apply to everyone.
The Research Details
Researchers collected information from 245 dialysis patients at three hospitals in Benin during 2023. This was a cross-sectional study, meaning they looked at all patients at one point in time rather than following them over months or years. Patients answered questions about their itching and skin problems, and doctors examined their skin carefully. The researchers used a standard itching scale (1-10) to measure how severe the itching was for each person.
They recorded information about each patient’s medical history, how long they’d been on dialysis, what type of dialysis access they had, and what medications they were taking. They also noted any skin conditions present. This approach allowed them to see which factors were connected to itching without testing new treatments.
This study design is practical for understanding a real-world problem affecting many dialysis patients. By looking at many patients at once, researchers could identify patterns and risk factors. The cross-sectional approach is good for describing a problem and finding associations, though it can’t prove that one thing directly causes another. Understanding these patterns helps doctors know which patients are at higher risk and what to watch for.
The study included a good-sized group of 245 patients, which makes the findings more reliable. The researchers used a standard, validated scale to measure itching rather than just asking patients vague questions. They performed both simple and advanced statistical analyses to identify risk factors. However, this study was done in one region of Africa, so results may not apply equally to all populations worldwide. The study describes what they found but cannot prove cause-and-effect relationships.
What the Results Show
About 40 out of every 100 dialysis patients in this study experienced itching. Most of these patients (91%) had mild to moderate itching rather than severe itching. The itching usually spread across the whole body or large areas rather than staying in one spot. Two-thirds of patients said their itching had lasted at least a year, showing this is a long-term problem.
The most common skin problems found were extremely dry skin (89% of itchy patients), nail problems like ridges or discoloration (77%), and darkening of the skin (27%). When researchers looked at what made itching more likely, they found four main risk factors: having been on dialysis for a long time, using a fistula (a surgically created connection between an artery and vein for dialysis), having severe dry skin, and having specific nail problems called Beau’s lines (horizontal ridges on nails).
Interestingly, patients taking oral diabetes medications had significantly less itching—about 75% less likely to have itching compared to those not taking these medications. Vitamin D supplements also appeared protective against itching.
The study found that patients without complete loss of urine production (anuria) had less itching, suggesting kidney function level matters. Patients without widespread skin darkening and without hair loss also had lower rates of itching. These secondary findings suggest that overall skin health and kidney function are connected to the itching problem.
Previous research has shown that itching is common in dialysis patients worldwide, affecting 20-90% depending on the population studied. This study’s finding of 40% fits in the middle of that range. The connection between dry skin and itching matches what other researchers have found. The protective effect of diabetes medications is interesting and somewhat unexpected, suggesting there may be shared biological pathways between diabetes control and itching that deserve further study.
This study only looked at patients in Benin, so results may not apply to other countries or populations with different genetics, climates, or healthcare systems. Because it’s a cross-sectional study (snapshot in time), researchers can’t prove that one factor directly causes itching—only that they’re associated. The study didn’t test any new treatments, so it can’t tell us what actually works best. Some important information about patients’ medications and medical history might have been incomplete or inaccurate.
The Bottom Line
If you’re on dialysis and experiencing itching: (1) Talk to your doctor about your dry skin—this is the strongest modifiable factor. Use moisturizers regularly and avoid very hot water. (2) Ask your doctor about vitamin D supplementation if you’re not already taking it. (3) Keep track of when itching started and what makes it better or worse. (4) If you’re on diabetes medication, continue taking it as prescribed—it may help with itching. These recommendations have moderate confidence based on this one study and should be discussed with your healthcare team.
This research is most relevant for people currently on hemodialysis, their family members, and their doctors. It’s especially important for dialysis centers in Africa and similar climates where dry skin is common. People with diabetes on dialysis should particularly note the protective effect of diabetes medications. However, if you’re not on dialysis or live in a very different climate, these specific findings may not apply to you.
Itching in dialysis patients is usually a long-term issue—most patients in this study had it for at least a year. Improvements in skin care and moisture might help within weeks to months. If medications are adjusted, changes could take several weeks to become noticeable. This isn’t a quick fix, but rather a chronic condition requiring ongoing management.
Want to Apply This Research?
- Daily itching log: Rate your itching on a scale of 0-10 each morning and evening. Note which body areas itch most. Track skin moisture (dry, normal, or moisturized) and any moisturizer use. This creates a pattern you can share with your doctor.
- Set a daily reminder to apply moisturizer to dry skin areas, especially after dialysis sessions. Log this in the app to build the habit. Track which moisturizers work best for you by noting the product name and your itching level the next day.
- Weekly review: Look at your itching patterns to see if certain days or activities make it worse. Monthly check-in: Share your itching log with your dialysis team to discuss whether any medication or treatment changes might help. Track any new skin changes (nail problems, discoloration) and report them to your doctor.
This research describes patterns found in one study of dialysis patients in Benin and should not be used to diagnose or treat itching on your own. Itching in dialysis patients can have many causes and requires evaluation by your healthcare provider. Always consult with your nephrologist (kidney doctor) or dermatologist (skin doctor) before making changes to your dialysis care, medications, or treatment plan. This information is educational and not a substitute for professional medical advice. Individual results may vary based on your specific health situation, location, and medical history.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.