Acupressure and Transcutaneous Electrical Acupoint Stimulation for Improving Uremic Pruritus: A Randomized, Controlled Trial.

Context • Uremic pruritus, a frequent and compromising symptom for patients with advanced or end-stage renal disease (ESRD), strongly reduces the patient's quality of life. Pruritus may be extremely difficult to control because therapeutic options are limited. Topical products are frequently used for easing pruritus, but their effects are generally temporary and marginal. Although acupressure and electrical-stimulation methods for the application of acupressure have been evaluated separately in terms of pruritus efficiency in different studies, the existence of any difference between the efficacies of the 2 methods has not been assessed yet. Objective • The study intended to test the effectiveness of acupressure and transcutaneous electrical acupoint stimulation (TEAS) on uremic pruritus in patients who were receiving the routine hemodialysis treatment. Design • The study was a randomized, controlled trial. Setting • The study took place in hemodialysis units located in hemodialysis centers in Turkey. Participants • Participants were patients in the hemodialysis units who were under hemodialysis treatment and had experienced uremic pruritus. Intervention • Participants were randomly assigned to the acupressure group (intervention group), the TEAS group (intervention group), or the control group. For the 2 intervention groups, the treatment was applied 3 ×/wk during the 4 wk of the study on the large intestine (LI-11) acupuncture points in the arm, for a total of 12 sessions. Outcome Measures • The study measured the severity of participants' pruritus using a patient information form and a visual analogue scale (VAS). The data were collected at baseline and posttreatment. Results • A total of 75 patients participated in the study. The results indicated that patients in the acupressure and TEAS groups had significant reductions from baseline to posttreatment in their levels of discomfort from uremic pruritus compared with patients in the control group. However, no differences existed between the acupressure and the TEAS patients in terms of outcome measures. Conclusions • The research team concluded that both acupressure and TEAS applied to hemodialysis patients was effective in reducing uremic pruritus. The study provided support for an alternative method for health care providers in managing hemodialysis patients with symptoms of uremic pruritus.