الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Pruritus was the most common cutaneous abnormality encountered in fifty five percent of the egyptian CRF patients on hemodialysis. Its prevalence among hemodialysis patients ranges from 19 to 90% in the other previous studies.(24;54) It is one of the most characteristic and annoying cutaneous symptoms of CRF.(55) It is not present in acute renal failure and does not necessarily subside with dialysis although it improves with kidney transplantation.(54)
The pathophysiology of uremic pruritus is poorly understood. Recently, four hypotheses for the underlying pathophysiological mechanisms of uremic pruritus have been proposed, the immune hypothesis ( immune system derangement resulting in proinflammatory state ), opioid hypothesis (imbalance of endogenous opioidergic system),dermatological abnormalities and neuropathic mechanism.(67)
It has been associated with the degree of renal insufficiency (urine output of < 500 mL),(2) dry skin, retention of middle molecules (molecular weight range 300 daltons – 12,000 daltons) such as β2MG, AGE, and PTH that is thought to cause pruritic symptoms in CRF patients.
This study was done to assess the relation of β2MG, the protype of middle molecules, to pruritus in end stage renal disease patients on hemodialysis. The study was done on thirty four patients , all of them are ESRD on hemodialysis. Patients are divided in two groups: first group with pruritus and second group without pruritus.
Patients included in this study were subjected to the following : Detailed history taking , Clinical examination , Kidney function test (by estimation of serum urea and serum creatinine by cobas 501 chemistry autoanalyzer) and Laboratory estimation of serum β2MG levels by ELISA technique by using kits(β2MG Enzyme Immunoassay kits).
The mean age for pruritic and non pruritic patients were 41.6 ± 10.9 and 37.0 ± 7.8, respectively. The duration of dialysis ranged from 1-7 years in non pruritic group with a mean duration 3.59 ± 1.70 compared to 3-16 years in pruritic group with a mean duration 10.53 ± 3.71.
The results of the study showed the serum level of β2MG was significantly higher in pruritic group both in pre dialysis and post dialysis results than in non pruritic group. Also , level is higher in post dialysis results than in pre dialysis in both groups and this is statistically significant.
The diagnostic performance of β2MG for predicting pruritus in patients with ESRD is good as evidenced by AUC was 81.7.This is statistically significant. Best cut off point for predicting pruritus in ESRD is >2.05 in pre dialysis and >2.66 in post dialysis.