What Causes Itchy Skin Inspite Of Having CKD And Diabetes?

Posted on Mon, 9 Jun 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 9 Jun 2014 Answered on

Mon, 30 Jun 2014 Last reviewed on

Question : Previous Question : Dear Doc - This is for my mother who is 70 years old , CABG , CKD and insulin dependent . Since 2-3 days she has having itchy skin (repeat issue) . Last year she had incident of cellulitis for which she was hospitalized as well . Currently her sugar is well under control . I told her to start Alaspan (given by the doctor for the itchy skin) again & apply Suthol for local application . Is there any OTC medicine which she can take .Please do advice
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Dear Doctor - You had told me to click a picture for you to gauge the condition . I am attaching a picture of my mother's back , it severely itches ...She has been using Cetaphil soap for washing , which is not helping . May I request you to help with an ointment , which can help her condition ? Appears to be some kind of infection to me . Please help.

Answered by Dr. Hardik Pitroda (2 hours later)

Brief Answer:
Betamethasone, gabapentin, diet

Detailed Answer:
Hello XXXXXXX

Thank you for posting on HCM and appreciate your concern regarding the skin condition of your mother.

From the picture and the history, it seems the skin condition is secondary to chronic kidney disease or alternatively it could be due to medications or dialysis (if she is going through it !).

Though the definitive diagnosis is still difficult to make from this picture, i would suggest you some treatment that will definitely help in bringing about some symptomatic relief to her.

Continue taking Alaspan as advised by your doctor.

Add tablet containing gabapentin (Nurokind-G etc) twice a day as it will decrease the itching at central and peripheral nervous system.

For local application, apply a solution containing betamethasone mixed with a strong moisturiser like Cetaphil DAM moisturising lotion atleast twice a day.

Also apply about pea-size amount of gel containing benzoyl peroxide and adapalene at night time over back area gently without rubbing.

Additionally, cold sponging couple of times a day will also help in alleviating the itching.

Continue using Cetaphil bar for daily bath.

Make sure she takes low protein but high amino acid diet.

Follow the above regimen for three weeks and let me know how she feels. I am pretty sure this will be able to ease out her problem to great extent.

Thanking you
Dr Hardik Pitroda

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Hardik Pitroda (26 minutes later)

Thank you doctor ! She already is on Pregabalin 75 twice a day , should GABAPENTIN still be added ? If yes , for what duration ? Thanking you once again.

Answered by Dr. Hardik Pitroda (3 hours later)

Brief Answer:
Gabapentine preferred

Detailed Answer:
Hello XXXXXXX
Gabapentin is preferred over pregabalin in cases of itching secondary to renal causes.
I usually advise gabapentin in a dose of 300mg twice day to start with but can be increased upto 1200mg thrice a day theoretically but i think 300mg thrice a day should be sufficient enough.
Take them for atleast couple of months.
Let me know about your mother's condition after 3 weeks of treatment.
Thank you
Dr Hardik Pitroda

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj