维生素 D 和窄带紫外线 B 光疗法治疗慢性肾病相关性瘙痒症。

IF 2.9 3区医学 Q1 UROLOGY & NEPHROLOGY

Kidney Research and Clinical Practice Pub Date : 2024-03-01 Epub Date: 2023-03-22 DOI:10.23876/j.krcp.22.153

Youn Kyung Kee, Hee Jung Jeon, Jieun Oh, Dong Ho Shin

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引用次数: 0

摘要

背景：窄带紫外线B（NB-UVB）光疗除了能改善血清维生素D平衡外，还能有效治疗慢性肾脏病相关性瘙痒症（CKD-aP）。我们根据 NB-UVB 光疗后血清维生素 D 水平的变化，研究了 CKD-aP 的改善程度：这是一项对接受血液透析的难治性 CKD-aP 患者进行的前后对比临床研究。NB-UVB 光疗每周三次，持续 12 周。CKD-aP患者对NB-UVB光疗的反应根据瘙痒强度随时间的变化进行评估。快速反应的定义是在接受 NB-UVB 光疗的前 6 周内，视觉模拟量表（VAS）评分降低≥50%：本研究共纳入 34 名患者。虽然光疗后血清中 25- 羟基维生素 D [25(OH)D] 浓度显著增加，中位数为 17.4 纳克/毫升，但其他血清学参数没有变化。与Δ25（OH）D ≤17.4 ng/mL的患者相比，Δ25（OH）D ≥17.4 ng/mL的患者接受 NB-UVB 光疗后，随着时间的推移，瘙痒强度的 VAS 评分明显降低（p = 0.001）。10名患者为快速反应者。多变量逻辑回归分析表明，Δ25（OH）D 与快速反应独立相关（几率比，1.29；95% 置信区间，1.02-1.63；p = 0.04）：结论：NB-UVB 光疗对 CKD-aP 患者的疗效与其血清维生素 D 水平的升高相关。要明确 NB-UVB 光疗与 CKD-aP 患者血清维生素 D 水平之间的关系，还需要进一步设计完善的临床和实验研究。

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Vitamin D and narrowband ultraviolet B phototherapy for chronic kidney disease-associated pruritus.

Background: In addition to improving the serum vitamin D balance, narrowband ultraviolet B (NB-UVB) phototherapy can effectively treat chronic kidney disease-associated pruritus (CKD-aP). We investigated the degree of CKD-aP amelioration according to changes in the serum vitamin D level after NB-UVB phototherapy.

Methods: This was a before-after clinical study in patients with refractory CKD-aP on hemodialysis. NB-UVB phototherapy was administered thrice weekly for 12 weeks. The response of CKD-aP to NB-UVB phototherapy was assessed as the change in pruritus intensity over time. A rapid response was defined as a reduction in the visual analog scale (VAS) score of ≥50% within the first 6 weeks of NB-UVB phototherapy.

Results: We included 34 patients in this study. Although serum 25-hydroxy vitamin D [25(OH)D] concentrations increased significantly, by a median of 17.4 ng/mL, after the phototherapy course, other serologic parameters did not change. NB-UVB phototherapy reduced the VAS score for pruritus intensity over time significantly more in patients with Δ25(OH)D of >17.4 ng/mL than in patients with Δ25(OH)D of ≤17.4 ng/mL (p = 0.001). Ten patients were rapid responders. Multivariate logistic regression analysis showed that Δ25(OH)D was independently associated with rapid response (odds ratio, 1.29; 95% confidence interval, 1.02-1.63; p = 0.04).

Conclusion: The effect of NB-UVB phototherapy on patients with CKD-aP correlated with their increase in serum vitamin D levels. Further well-designed clinical and experimental studies are needed to clarify the relationship between NB-UVB phototherapy and serum vitamin D levels in patients with CKD-aP.

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来源期刊

Kidney Research and Clinical Practice UROLOGY & NEPHROLOGY-

CiteScore

4.60

自引率

10.00%

发文量

审稿时长

10 weeks

期刊介绍： Kidney Research and Clinical Practice (formerly The Korean Journal of Nephrology; ISSN 1975-9460, launched in 1982), the official journal of the Korean Society of Nephrology, is an international, peer-reviewed journal published in English. Its ISO abbreviation is Kidney Res Clin Pract. To provide an efficient venue for dissemination of knowledge and discussion of topics related to basic renal science and clinical practice, the journal offers open access (free submission and free access) and considers articles on all aspects of clinical nephrology and hypertension as well as related molecular genetics, anatomy, pathology, physiology, pharmacology, and immunology. In particular, the journal focuses on translational renal research that helps bridging laboratory discovery with the diagnosis and treatment of human kidney disease. Topics covered include basic science with possible clinical applicability and papers on the pathophysiological basis of disease processes of the kidney. Original researches from areas of intervention nephrology or dialysis access are also welcomed. Major article types considered for publication include original research and reviews on current topics of interest. Accepted manuscripts are granted free online open-access immediately after publication, which permits its users to read, download, copy, distribute, print, search, or link to the full texts of its articles to facilitate access to a broad readership. Circulation number of print copies is 1,600.