Difelikefalin in Hemodialysis Patients with Pruritus

To the Editor: Fishbane et al. (Jan. 16 issue) 1 report the results of the KALM-1 trial of difelikefalin in the management of uremic pruritus. In the article and at a press conference, 2 Fishbane et al. suggested that there are no other adequate therapies. However, a growing body of literature 3,4 favors the efficacy of gabapentin for uremic pruritus, and there is increasing clinical experience with low-dose gabapentin in the successful management of this condition. Furthermore, the trial by Fishbane and colleagues reveals that the use of antihistamines for uremic pruritus is a common practice in the United States. This is troubling . . .