Beneficial effect of zinc supplementation on pruritus in hemodialysis patients with special reference to changes in serum histamine levels

Abstract

1)そう痒のある慢性透析患者19例で, 血清亜鉛濃度は低値を, ヒスタミン濃度は高値を示した.亜鉛濃度とヒスタミン濃度の間には, 有意な負の相関が認められた.2)そう痒患者に連日硫酸亜鉛445 mgを経口で2ヵ月間投与し, 53%にそう痒の改善がみられた.治療前に比較して, 血清亜鉛濃度は有意に上昇し, ヒスタミン濃度は有意に低下した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