Table 1 Characteristics of included studies

Gunal et al. (2004) [17]

R DB PC cross-over

N = 25

HD 3×/week, 4–5-h sessions

Kt/V 1.37 ± 0.35 (0.5–1.93)

Males 56.0 %

Mean age 55 ± 11 (32–77)

Baseline:

Ca 2.15 ± 0.23 mmol/L

PO₄ 1.45 ± 0.39 mmol/L

iPTH 20.5 ± 14.3 pmol/L

Refractory to antihistamines, nicergoline, moisturizers

NR

Gabapentin 300 mg 3× weekly post-HD × 4 weeks, then 1-week washout, then placebo × 4 weeks vs. the reverse

In chronological order:

Baseline VAS (0–10) 8.5 ± 0.94

After 4 weeks placebo 7.6 ± 2.6 (p = 0.098)

After 1-week washout 7.9 ± 1.1

After 4 weeks gabapentin 1.2 ± 1.8 (p = 0.0001)

Follow-up: 9 weeks

3^a

Mild to moderate somnolence, dizziness, fatigue

Naini et al. (2007) [19]

RCT DB PC

N = 34

HD 2×/week

Males 47.1 %

Mean age 62 ± 10 (43–81)

Refractory to antihistamines

Hgb < 70 g/L,

PTH > 33 pmol/L,

PO4 > 2.26 mmol/L,

Other skin disease

Gabapentin 400 mg 2× weekly post-HD vs. placebo × 4 weeks

Baseline VAS (0–10) 7.2 ± 2.3

After 4 weeks 6.7 ± 2.6 vs. 1.5 ± 1.8 (p < 0.001)

Follow-up: 4 weeks

4^a

Mild to moderate somnolence, dizziness, nausea

Tol et al. (2010) [20]

R blinded cross-over

N = 14

HD 3×/week, 4–5-h sessions

Kt/V 1.33 ± 0.17 (1.0–1.7)

Males 50 %

Mean age 59.7 ± 17.2 (41–88)

Baseline:

Ca 2.23 ± 0.18 mmol/L

PO4 1.62 ± 0.29 mmol/L

iPTH 31.68 ± 12.87 pmol/L

Refractory to antihistamines, nicergoline, moisturizers

<18 years old, pregnant/lactating

Gabapentin 300 mg 3× weekly post-HD × 8 weeks, then 1-week washout, then placebo (unknown duration)

Pruritus VAS score (0–10):

Before gabapentin 7.6 ± 1.2

After gabapentin 1.3 ± 1.4 (p < 0.01)

Follow-up: NR

2^a

No side effects observed

Razeghi et al. (2009) [18]

DB PC single-arm cross-over

N = 34

HD 3×/week, 4-h sessions

Kt/V 1.31 ± 0.2

Males 23 %

Mean age 58.4 ± 12.5 (28–73)

Baseline:

Ca 2.38 ± 0.63 mmol/L

PO4 2.02 ± 0.75 mmol/L

iPTH 12.2 ± 11.33 pmol/L

Refractory to antihistamines and moisturizers

Skin lesions, metabolic diseases, drug allergies, non-compliance

Gabapentin 100 mg 3× weekly post-HD × 4 weeks, then 1-week washout, then placebo × 4 weeks

In chronological order:

Baseline VAS (0–100) 100

After 4 weeks gabapentin 6.4 ± 8.5 (p < 0.001)

After 1-week washout 15 ± 11.3 (p < 0.001)

After 4 weeks placebo 81.9 ± 11.1 (p < 0.001)

Follow-up: 9 weeks

2^a

Dizziness, drowsiness, and fatigue (2)

Marquez et al. (2012) [14]

Quasi-randomize, OL cross-over

N = 19

HD 3×/week, 4-h sessions

Kt/V 1.23 ± 0.3

Males: NR

Mean age 54 ± 18

Baseline:

Ca 2.35 ± 0.3 mmol/L

PO4 1.65 ± 0.53 mmol/L

iPTH 5.79 ± 5.0 pmol/L

NR

Chronic skin or liver diseases, malignancy, chronic opiates or corticosteroids

Gabapentin 300 mg 3× weekly post-HD × 3 weeks, then 1-week washout, then desloratadine 5 mg 3× weekly × 3 weeks, vs. the reverse

Baseline VAS (0–10) 5.95

After 3 weeks gabapentin 4.6 (p = 0.07)

After 3 weeks desloratadine 3.44 (p = 0.004)

Follow-up: 7 weeks

1^a

Fatigue and somnolence (9)

Medication discontinuation (4)

Rayner et al. (2012)[15]

Step-wise OL

N = 40 HD (71 including PD and CKDND)

Kt/V: NR

Males 77.5 %

Median age 64 (35–88)

Baseline:

Ca 2.45 mmol/L

PO4 1.54 mmol/L

iPTH 25.3 pmol/L

Refractory to emollients or antihistamines 58 % of HD patients tried antihistamines

NR

Gabapentin 100 mg daily post-HD, adjusted to efficacy and tolerability; final median 700 mg/week

Min: 100 mg post-HD

Max: 900 mg daily

Significant reduction of itch 31 (77.5 %)

Median follow-up: 2.5 months

5^b

Unknown adverse event (8)

Chiekh Hassan et al. (2015)[16]

R, cohort

N = 13 HD with pruritus (15 total)

Kt/V: NR

Males 73.3 %

Mean age 70.1 ± 10.6

Baseline:

Ca 2.26 ± 0.2 mmol/L

PO4 1.6 ± 0.5 mmol/L

iPTH 16.8 pmol/L (IQR 11.3–23.9)

NR

Identifiable non-CKD cause of RLS or pruritus, incomplete/missing data, on gabapentin prior to attending institution

Gabapentin 100 mg q2d, adjusted by 25 mg for efficacy and tolerability

Final average 90 mg/day

POS-S Renal score (pruritus):

Baseline 17.9

Subsequent visits: NR, p < 0.05

Follow-up: 27 weeks

6^b

Unsteadiness (2)

Blurred vision (1)