Dialysis Technician Practice Exam

What is the most common cause of pruritus in patients undergoing dialysis?

1. Hypokalemia

2. Hyperphosphatemia or Uremia

3. Dry Skin

4. Medications

The correct answer is: Hyperphosphatemia or Uremia

The most common cause of pruritus in patients undergoing dialysis is indeed hyperphosphatemia or uremia. Pruritus is a prevalent symptom experienced by many dialysis patients, primarily due to the accumulation of waste products in the blood as a result of kidney failure. Hyperphosphatemia occurs when there is an elevated level of phosphate in the blood, a common issue in patients with renal impairment because the kidneys are less able to excrete phosphate. This condition can lead to the deposition of calcium phosphate in the skin and other tissues, which can irritate the skin and cause itching. Uremia, a condition characterized by elevated levels of urea and other nitrogenous waste products in the blood, can also contribute significantly to itching. It results from the kidneys' inability to filter out these wastes effectively, leading to systemic effects that include skin manifestations such as pruritus. While dry skin can indeed contribute to itching, especially in patients undergoing dialysis due to the frequent use of water and dialysate, it is not the primary cause as hyperphosphatemia and uremic toxins have a more pronounced effect. Similarly, medications can also cause skin reactions, but they are less common compared to the direct physiological impacts of uremia