Targeting CKD-aP at the Source: Key Mechanisms and Treatments

Faculty: Steven Fishbane, MD


Faculty: Maurizio Gallieni, MD

Drs. Steven Fishbane and Maurizio Gallieni discuss chronic kidney disease-associated pruritus (CKD-aP), a prevalent and under-recognized complication of CKD. They review the epidemiology, pathophysiology, and treatment strategies supported by pivotal phase 3 trials and new European S2k guidelines, including the use of difelikefalin, a kappa-opioid receptor agonist. Additional insights from biomarker analyses in the KALM studies underscore the link between inflammation and pruritus severity, suggesting a dual mechanism of action for difelikefalin. The program emphasizes the importance of actively screening for CKD-aP and using validated tools to assess symptom burden in clinical practice.