​What is Nephrology - What role does itching play in renal illness, and how can you deal with it?

​What is Nephrology - What role does itching play in renal illness, and how can you deal with it? 
Itching, or pruritus, is a typical symptom of End-Stage Kidney Disease. It can be unforgiving in severe circumstances. Although the etiology is usually benign (see xerosis), it can cause secondary problems such excoriations and lichen simplex chronicus, which can be disfiguring in severe cases.
 As a conservative treatment, emollients, moisturizing lotions, keratolytic agents, and hydration are frequently prescribed.

 Phototherapy (ultraviolet B radiation [UVB] given as total body irradiation three times a week for a total of eight to ten sessions) has been demonstrated to be effective in some circumstances. UVB (wavelength 280 to 315 nm) has been suggested to inactivate specific pruritogenic compounds and induce the synthesis of antipruritic metabolites. 

Malignancy is a considerable danger, particularly in fair-skinned persons. Topical capsaicin (0.025 percent) has been shown to relieve localized itch by lowering substance P levels in cutaneous type C sensory nerve terminals. 

Topical tacrolimus (0.03 percent for 3 weeks, then 0.01 percent for another 3 weeks) may be useful, but it is not advised as a first-line therapy or for long-term use because it can predispose to dermatologic malignancies. 

Gabapentin (100-300 mg after each dialysis treatment) provides antipruritic properties as well. Depression of the central nervous system is one of the most common side effects. 
Antipruritic characteristics are found in m-opioid receptor antagonists such as per os (PO) naltrexone. Intranasal butorphanol (a F06BF06B-opioid receptor agonist and m-opioid receptor antagonist) belongs to the same family. PO-activated charcoal, selective serotonin antagonists (ondansetron and granisetron), oral cromolyn, cholestyramine, thalidomide, erythropoietin, and intravenous lidocaine are some of the other therapy possibilities.