Certified Dialysis Nurse Practice Test

The symptoms of pruritus, or itching, experienced by renal patients are primarily triggered by high phosphate levels in the blood. This condition, known as hyperphosphatemia, is common in patients with chronic kidney disease because their kidneys are less able to excrete phosphate. The accumulation of phosphate can lead to the development of secondary hyperparathyroidism, which in turn can stimulate nerve endings in the skin, resulting in the sensation of itching.

Furthermore, elevated phosphate levels can contribute to the formation of calcium-phosphate crystals in the skin, exacerbating the itching. Managing phosphate levels through dietary restrictions, phosphate binders, and dialysis is essential for alleviating this symptom in renal patients.

Inadequate hydration, excessive calcium on the skin, and allergic reactions to medications may contribute to skin discomfort or alterations in skin condition but are not the primary physiological triggers for pruritus in patients with renal impairment. Thus, understanding the relationship between high phosphate levels and pruritus is crucial for tailored patient care and symptom management.