Document Detail


Treatment of resistant pruritus from cholestasis with albumin dialysis: combined analysis of patients from three centers.
MedLine Citation:
PMID:  20580987     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Albumin dialysis using molecular adsorbent recirculating system (MARS) is a new procedure for treating resistant pruritus from cholestasis, but it is usually published as a case report or a short series. Therefore, we analyzed patients with resistant pruritus treated with MARS from three centers, to assess the changes on pruritus and the indices of cholestasis. METHODS: Twenty patients (12 female, mean age: 51+/-3.4 years) with chronic cholestatic liver disease or chronic liver-graft rejection were evaluated. The severity of pruritus was assessed using a visual analogue scale (VAS) before and after treatment, and 30 days thereafter. Liver tests, including total bilirubin, alkaline phosphatase, gamma-glutamyl-transferase, cholesterol, triglycerides, and total bile acid were also determined, as well as the number of sessions and the coupled procedure (dialysis or perfusion). RESULTS: Albumin dialysis resulted in a decrease of pruritus (VAS: from 70.2+/-4.8 to 20.1+/-4.2, p<0.001), which partially resumed after 30 days (38.7+/-6.6). VAS decreased by 72% immediately after treatment and by 51% after 1 month. Pruritus decreased in all but one patient. MARS resulted in a significant bile acid decrease of 41% after treatment and by 37% after 1 month. The effect of MARS on pruritus and markers of cholestasis was similar in patients with different diseases and was independent of the coupled procedure. The improvement of pruritus in individuals was positive in 75% of patients. No major adverse effects were observed. CONCLUSIONS: Albumin dialysis using MARS is an effective procedure for managing resistant pruritus in most patients with chronic cholestasis and graft rejection.
Authors:
Albert Parés; Manuel Herrera; Juan Avilés; Miquel Sanz; Antoni Mas
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-05-07
Journal Detail:
Title:  Journal of hepatology     Volume:  53     ISSN:  0168-8278     ISO Abbreviation:  J. Hepatol.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-06     Completed Date:  2010-11-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  307-12     Citation Subset:  IM    
Copyright Information:
Copyright 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Affiliation:
Liver Unit, Hospital Clinic, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain. pares@ub.edu
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MeSH Terms
Descriptor/Qualifier:
Albumins / therapeutic use*
Bile Acids and Salts / blood
Cholestasis / blood,  complications*,  physiopathology
Chronic Disease
Dialysis Solutions / therapeutic use*
Female
Graft Rejection / blood,  complications,  physiopathology
Hemofiltration / methods*
Humans
Liver Function Tests
Liver Transplantation
Male
Middle Aged
Pain Measurement
Pruritus / etiology,  therapy*
Renal Dialysis / methods*
Retrospective Studies
Severity of Illness Index
Treatment Outcome
Chemical
Reg. No./Substance:
0/Albumins; 0/Bile Acids and Salts; 0/Dialysis Solutions
Comments/Corrections
Comment In:
J Hepatol. 2010 Aug;53(2):228-9   [PMID:  20494469 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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