If your kidneys have failed and you need dialysis, your skin can become really dry and itchy. Doctors call this type of itching uremic pruritus or chronic kidney disease-associated pruritus. Although not typically serious, uremic pruritus can be a pain. A severe case of itchy skin can distract you during the day and make it hard to sleep at night.
Here’s why you might feel itchy and what you can do to get some relief.
What’s Going on With Your Skin
Dialysis removes waste products and extra fluid from your blood. Severe itching can affect your whole body or make just a few parts of your body, such as your back, head, arms, or stomach, become really dry.
Doctors aren’t sure why advanced chronic kidney disease causes itchy skin, but some reasons might include:
Less fluid in your body. Dialysis removes a lot of fluid from your body. To stay as healthy as you can, you also have to drink less water and other liquids between treatments. But what’s good for your kidneys can be hard on your skin. You’re more likely to feel itchy when your skin doesn’t hold on to enough moisture.
Smaller sweat glands. Less water in your body can also start to shrink your sweat glands. As they get smaller, your skin may start to get red, scaly, and very dry.
High levels of phosphorus. Sometimes, itchy skin is caused by high amounts of phosphorus in your blood. Your body needs phosphorus to stay healthy and to keep your bones strong, but kidney damage can cause too much of this mineral to build up in your body. Itchy skin is a common side effect of phosphorus buildup, which doctors call hyperphosphatemia.
Your immune system. When you live with chronic kidney disease, your immune system may respond and you may start to feel itchy.
Not enough dialysis. Dialysis isn’t a one-size-fits-all treatment. If you aren’t having the right amount of treatment you need, you may start to notice changes in your skin. Other signs that you may need more dialysis include weight loss, not being able to sleep, loss of taste, upset stomach, nerve pain, and high blood pressure.
Damaged nerves. Your body has special nerve endings in the outer layer of the skin that let your brain know if you are itchy. If these nerve endings get damaged, they can become too sensitive. They may keep sending your brain signals that your skin feels itchy and make you want to scratch.
Allergies. If you only feel itchy during dialysis treatment, it might be caused by something your care team is using during the session. If you have an urge to scratch at other times, you could have an allergy to something else you come in contact with, such as lotion, soap, perfume, or laundry detergent. Many scents and dyes in these products can inflame your skin.
Medicines. Itchy skin is a side effect of some drugs, such as opioids and a few types of blood pressure drugs.
Other health concerns. Kidney disease isn’t the only condition that can make you itch. Rough, scratchy skin can also be a symptom of other health issues, including diabetes, HIV, liver disease, or overactive thyroid.
When to Call Your Care Team
Even if your itchy skin is mild or comes and goes, make sure to tell your care team. It could be a sign that you need more dialysis, or that your doctor needs to make changes to your medicines or the food you eat.
It’s helpful for your care team to know:
- Which parts of your body are itchy
- When the itching happens
- When it gets better or worse
- What you’ve tried to make the itch go away
Your doctor can suggest a treatment that can help you get some relief. Certain creams or ointments for your skin might ease itchiness, or a drug may quiet the nerve signals that tell your brain you’re itchy. In some cases, your doctor may also suggest you see a skin doctor (dermatologist).