Chronic kidney disease-associated pruritus: a perspective on skin barrier damage

Abstract Chronic kidney disease-associated pruritus (CKD-aP) is a common complication in patients with end-stage kidney disease (ESKD) that seriously affects quality of life. Its pathogenesis is complex, involving toxin accumulation, immune dysregulation, nerve conduction changes, and other factors, but its relationship with skin barrier function has not been widely studied. From the perspective of skin barrier damage, this article systematically elaborates on the structure and function of the skin barrier, the pathological changes of the skin barrier in uremic patients, and its mechanism in the occurrence of pruritus, and analyses in detail how the pathological changes lead to the generation and maintenance of pruritus. In addition, this review also presents the treatment strategies for CKD-aP for skin barrier repair, which provides a novel therapeutic insight.