Back
For best output, select "Paper Size" as "A4" and "Margin" as "0" or "None".
To save or print to PDF, please select Print Destination > Save as PDF, enable Background Graphics under "More Settings", then click "Save".
During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Chronic kidney disease associated pruritus (CKDaP) is common in individuals receiving chronic haemodialysis, and severe itch can adversely impact sleep and quality of life. Difelikefalin is a kappa-opioid receptor agonist indicated for the treatment of moderate to severe CKDaP and reported to improve itch and quality of life. Most patients enrolled in existing studies of difelikefalin have not received treatment with gabapentinoids, the only class of medication previously found to be highly efficacious in CKDaP, and no head-to-head comparisons exist between the two classes of pharmacotherapy. The aim of this study is to determine if difelikefalin is efficacious for CKDaP in patients who have failed treatment with gabapentin or pregabalin due to inefficacy or intolerability.
We retrospectively collected data for patients treated with difelikefalin 0.5mcg/kg after each haemodialysis session by the kidney supportive care (KSC) team in a single nephrology unit in Australia between Dec 2022 and Sep 2025. For each patient, the diagnosis of CKDaP was made by an experienced KSC clinician through clinical history and skin examination. Patients were included if they were on chronic haemodialysis, experienced moderate to severe itch secondary to CKDaP with Worse-Itch Numerical Rating Scale (WI-NRS) of ³4, AND received prior or current treatment with gabapentin or pregabalin. WI-NRS was reassessed at weeks 1, 4, 8, 12, and 6 monthly thereafter.
25 patients were included: mean age 68 years, 18 (72%) male, and 11 (39%) were White. At baseline, 14/25 (56%) were currently and 11/25 (44%) were previously treated with gabapentin or pregabalin for indications including CKDaP, restless legs syndrome, peripheral neuropathy, or a combination of symptoms. Median WI-NRS at baseline was 8/10, which improved to 1/10 at week 4, 3/10 at week 8, and 2/10 at week 12 (Figure 1). Within the initial 12 weeks, 21/25 (84%) patients experienced a >/=4-point reduction in WI-NRS, including 13/25 (52%) with symptom resolution (WI-NRS 0-1/10). In 4/25 (16%) patients, difelikefalin was ineffective; 2 of them also reported confusion (polypharmacy n=1, pre-existing cognitive impairment n=1), and all 4 discontinued within 12 weeks. Difelikefalin was well tolerated, with 1 additional report of mild diarrhoea that did not lead to cessation. Other patients discontinued difelikefalin due to death from unrelated cause (n=7), kidney transplantation (n=2), and hospitalisation for other conditions (n=2). Patients who continued treatment to 6 and 12 months had sustained improvement in itch, median WI-NRS of 1 and 3 respectively (Figure 1). 2 patients experienced relapses in itch (WI-NRS increase of >3-points after initial >3-point reduction) and were diagnosed with conditions unrelated to CKDaP, and itch resolved after appropriate alternate treatments.
Figure 1 – Worse-Itch Numerical Rating Scale (WI-NRS) after initiation of Difelikefalin
Difelikefalin is an effective and well-tolerated treatment for CKDaP in patients who have failed treatment with gabapentin or pregabalin, therefore providing a useful therapeutic option for refractory cases of CKDaP.
