PROSPECTIVE COHORT EVALUATING EFFICACY OF HA-130 HEMOPERFUSION IN REDUCING CHRONIC KIDNEY DISEASE–ASSOCIATED PRURITUS AMONG MAINTENANCE HEMODIALYSIS PATIENTS IN AN OUTPATIENT DIALYSIS SETTING

 

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https://storage.unitedwebnetwork.com/files/1099/841219495737b24e667c3fdb0a4de2e3.pdf
PROSPECTIVE COHORT EVALUATING EFFICACY OF HA-130 HEMOPERFUSION IN REDUCING CHRONIC KIDNEY DISEASE–ASSOCIATED PRURITUS AMONG MAINTENANCE HEMODIALYSIS PATIENTS IN AN OUTPATIENT DIALYSIS SETTING

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ALBERT JOSEPH
ARANZA
ALBERT JOSEPH ARANZA albertjosepharanza@gmail.com VETERANS MEMORIAL MEDICAL CENTER DEPARTMENT OF MEDICINE QUEZON CITY Philippines *
RICARDO FRANCISCO albertjosepharanza@gmail.com VETERANS MEMORIAL MEDICAL CENTER DEPARTMENT OF MEDICINE QUEZON CITY Philippines -
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Chronic kidney disease–associated pruritus (CKD-aP) is a distressing and underrecognized complication among patients receiving maintenance hemodialysis (HD). It significantly diminishes quality of life and increases morbidity. Despite its high prevalence, conventional treatments such as emollients, gabapentinoids, antihistamines, and ultraviolet light therapy often provide limited relief. The condition’s multifactorial pathophysiology involves systemic inflammation, hyperphosphatemia, and the accumulation of uremic toxins, necessitating alternative therapeutic approaches. HA-130 hemoperfusion has the capacity to adsorb middle- and large-molecular-weight uremic toxins, including inflammatory mediators, that conventional HD does not efficiently eliminate.

A prospective cohort study was conducted involving 14 adult HD patients aged 18 years and older with CKD-aP unresponsive to conventional therapy. Participants underwent HA-130 hemoperfusion integrated into standard HD during the final 2 hours of each 4-hour HD session, performed every 2 weeks over an 8-week period. Pruritus severity was assessed using the Worst Itching Intensity Numerical Rating Scale (WI-NRS) at baseline, Week 4, and Week 8. Serum phosphorus, calcium, and parathyroid hormone (PTH) levels were measured at the same intervals. The primary endpoint was the change in WI-NRS from baseline to Week 8. Secondary outcomes included changes in biochemical parameters and correlations between pruritus severity and phosphorus reduction. Statistical analyses were conducted using paired t tests and Pearson correlation coefficients, with significance set at p < 0.05.

The mean age of participants was 61.5 years, with 71.4% male. Diabetic kidney disease was the leading cause of end-stage renal disease (ESRD). Mean WI-NRS scores decreased significantly from 8.21 at baseline to 3.79 at Week 8 (mean reduction: 4.42, p = 0.0001), demonstrating marked improvement in pruritus severity. Serum phosphorus levels decreased by 0.48 mg/dL (p = 0.0003), while mean serum calcium and PTH levels showed no statistically significant changes. A positive correlation was observed between reduction in phosphorus and improvement in pruritus severity (r = 0.533, p = 0.0495), suggesting that phosphorus control may contribute to symptom relief. No adverse reactions or hemodynamic instability were observed during hemoperfusion sessions.

HA-130 hemoperfusion significantly reduces CKD-aP severity in maintenance HD patients, with improvement partially associated with better phosphorus regulation. This intervention is safe, well tolerated, and may serve as an effective adjunct therapy for individuals unresponsive to conventional treatments. By targeting uremic and inflammatory mediators not removed by standard HD, HA-130 hemoperfusion offers a promising approach to improve quality of life in this population. Larger and longer-term studies are recommended to validate its sustained efficacy and explore combined strategies for managing CKD-aP’s multifactorial nature.

Kewords