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Condition

Chronic Kidney Disease-Associated Pruritus

Chronic kidney disease-associated pruritus is persistent itching in people with advanced kidney disease, thought to stem from an imbalance in the body's opioid signaling along with inflammation. The evidence is strongest for difelikefalin: in trials, 51% of people had a meaningful drop in itch intensity versus 28% on placebo, lasting up to 64 weeks. Most of that research was in people on hemodialysis, and about half did not reach that level of relief.

Sources: PMID 39712488

Supplements studied
0
Medicines and peptides
1
Graded outcomes
3
No supplement studies yetWe haven’t found supplement studies for Chronic Kidney Disease-Associated Pruritus. The medicines and peptides studied for it are listed below.

Prescription medicines and peptides studied, for context

These are not supplements. Most need a prescription, and some are research compounds with no approved use.

1 medicine or peptide

Difelikefalin (Korsuva)

Difelikefalin (Korsuva): outcomes studied for Chronic Kidney Disease-Associated Pruritus
GradeOutcomeEffectSizeStudiesPeopleStudies list
Itch-Related Quality of Life

Pooled analysis: 55.5% achieved ≥15-point Skindex-10 improvement vs 40.5% placebo (P<0.001). 52.1% achieved ≥5-point 5-D Itch improvement vs 42.3% placebo (P=0.01). Sustained benefits to 64 weeks.

Improves (the measure goes down)Large effect17 studies

Studies that measured itch-related quality of life

and 14 more on the Difelikefalin (Korsuva) page

Itch Intensity Reduction

KALM-1/2 Phase 3: 51% achieved ≥3-point WI-NRS reduction vs 28% placebo (P<0.001). Mean 4.2-point decrease vs 2.5-point placebo. Effects sustained up to 64 weeks. First FDA-approved treatment for CKD-aP.

Improves (the measure goes down)Large effect16 studies

Studies that measured itch intensity reduction

and 13 more on the Difelikefalin (Korsuva) page

Sleep Improvement

Significant improvement in itch-related sleep disturbance. Reduced nighttime awakening due to pruritus. Benefits consistent across demographic and disease characteristic subgroups.

Improves (the measure goes up)Large effect13 studies

Studies that measured sleep improvement

and 10 more on the Difelikefalin (Korsuva) page

Key findings

  • Itch-Related Quality of LifeDifelikefalin (Korsuva)Improves (the measure goes down)
  • Itch Intensity ReductionDifelikefalin (Korsuva)Improves (the measure goes down)
  • Sleep ImprovementDifelikefalin (Korsuva)Improves (the measure goes up)

Studies cited

17 studies from PubMed

  1. Difelikefalin in the treatment of hemodialysis patients with pruritus: a systematic review and meta-analysis.Frontiers in pharmacology, 2024 · PMID 39712488
  2. Chronic kidney disease-associated pruritus and quality of life with difelikefalin treatment: a post hoc analysis of phase 3 data using the Skindex-10 questionnaire.Clinical kidney journal, 2024 · PMID 39421431
  3. Pathways for Diagnosing and Treating CKD-Associated Pruritus: A Narrative Review.Canadian journal of kidney health and disease, 2024 · PMID 38680970
  4. Phase 2 Trial of Difelikefalin in Notalgia Paresthetica.The New England journal of medicine, 2023 · PMID 36780675
  5. Difelikefalin: A New κ-Opioid Receptor Agonist for the Treatment of Hemodialysis-Dependent Chronic Kidney Disease-Associated PruritusAnn Pharmacother, 2023 · PMID 35942600
  6. Safety and Tolerability of Difelikefalin for the Treatment of Moderate to Severe Pruritus in Hemodialysis Patients: Pooled Analysis From the Phase 3 Clinical Trial ProgramKidney Med, 2022 · PMID 36039153
  7. Efficacy of Difelikefalin for the Treatment of Moderate to Severe Pruritus in Hemodialysis Patients: Pooled Analysis of KALM-1 and KALM-2 Phase 3 StudiesKidney Med, 2022 · PMID 36016762
  8. A Phase 3 Trial of Difelikefalin in Hemodialysis Patients with PruritusN Engl J Med, 2020 · PMID 31702883
  9. Clinical Assessment of Tribulus terrestris Extract in the Treatment of Female Sexual DysfunctionClin Med Insights Womens Health · PMID 25574150
  10. Efficacy of Tribulus Terrestris for the treatment of premenopausal women with hypoactive sexual desire disorder: a randomized double-blinded, placebo-controlled trialGynecol Endocrinol · PMID 29172782
  11. Efficacy of Tribulus terrestris for the treatment of hypoactive sexual desire disorder in postmenopausal women: a randomized, double-blinded, placebo-controlled trialMenopause · PMID 27760089
  12. Tribulus terrestris for treatment of sexual dysfunction in women: randomized double-blind placebo - controlled studyDaru · PMID 24773615
  13. The inhibitory effects of nicotine on physiological sexual arousal in nonsmoking women: results from a randomized, double-blind, placebo-controlled, cross-over trialJ Sex Med · PMID 18331269
  14. Beneficial effects of Lepidium meyenii (Maca) on psychological symptoms and measures of sexual dysfunction in postmenopausal women are not related to estrogen or androgen contentMenopause · PMID 18784609
  15. Short- and long-term effects of Ginkgo biloba extract on sexual dysfunction in womenArch Sex Behav · PMID 18274887
  16. Triple-blind, placebo-controlled trial of Ginkgo biloba in sexual dysfunction due to antidepressant drugsHum Psychopharmacol · PMID 15378664
  17. Androgens and sexual function: a placebo-controlled, randomized, double-blind study of testosterone vs. dehydroepiandrosterone in men with sexual dysfunction and androgen deficiencyAging Male · PMID 19883295