The effect of topical herbal lipogel containing extracts of Ziziphus jujube and Echium amoenum on pruritus in hemodialysis patients: A double-blind randomized placebo trial

Pruritus is a troublesome symptom in patients with chronic kidney failure (CKF). Topical treatment is the first choice for many skin conditions including pruritus. This study examined the effect of topical lipogel containing Ziziphus jujube and Echium amoenum extracts on pruritus in hemodialysis (HD) patients. A double-blind crossover trial was conducted with 50 HD patients. A demographic and medical information form and the 12-item Pruritus Severity Scale were used to collect data. Participants were randomly assigned into a placebo group and an intervention group. The intervention was carried out for four weeks. The groups were then switched after a 2-week washout period and followed for the next four weeks. The severity of pruritus was measured before and once a week after the intervention for 4 weeks. The independent samples t-test, the Mann-Whitney U test, the chi-square test, and repeat measures analysis of variance (RMANOVA) were used to analyze the data. The mean baseline pruritus scores were 15.14±2.59 and 14.34±2.6 in the intervention and placebo groups, respectively (P=0.581). The mean pruritus score decreased by three points in the intervention group and one point in the placebo group at the end of the intervention. The results of the RMANOVA also showed that over time, the herbal lipogel significantly reduced the mean pruritus scores in the intervention group (P<0.0001), while it remained relatively unchanged in the placebo group. The use of a topical lipogel containing extracts of Ziziphus jujube and Echium amoenum can effectively reduce pruritus in HD patients. Therefore, this lipogel may safely be used to relieve pruritus in patients receiving HD.