Difelikefalin for the Treatment of Uremic Pruritus

The care of patients with end-stage kidney disease is complicated; patients and clinicians alike feel frustration because of our limited options for controlling many of the symptoms associated with this condition. In this context, a phase 3 trial of the drug difelikefalin to treat uremic pruritus in patients undergoing dialysis, the results of which are reported by Fishbane et al.1 in this issue of the Journal, merits commentary. There are both uremic and nonuremic causes of itching in patients undergoing dialysis. Uremic pruritus is associated with depression and other adverse outcomes. The pathophysiology of uremic pruritus is not certain but . . .