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Abstract: FR-PO422

The Utilization of Gabapentin and Pregabalin for the Treatment of CKD-Associated Pruritus and Other Indications in Manitoba

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis


  • Leon Mantilla, Silvia Juliana, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada
  • Whitlock, Reid, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada
  • Harasemiw, Oksana, University of Manitoba, Winnipeg, Manitoba, Canada
  • DiNella, Michelle SJ, Seven Oaks General Hospital, Winnipeg, Manitoba, Canada
  • Miciak, Gerald, Otsuka Canada Pharmaceutical Inc, Saint Laurent, Quebec, Canada
  • Bohm, Clara, University of Manitoba, Winnipeg, Manitoba, Canada
  • Komenda, Paul, University of Manitoba, Winnipeg, Manitoba, Canada
  • Tangri, Navdeep, University of Manitoba, Winnipeg, Manitoba, Canada
  • Collister, David Thomas, University of Manitoba, Winnipeg, Manitoba, Canada
  • Rigatto, Claudio, University of Manitoba, Winnipeg, Manitoba, Canada

Chronic kidney disease-associated pruritus (CKD-aP) frequently affects patients on dialysis, is associated with reduced quality of life, and was identified as a research priority by patients. Until recently there were no approved treatments for CKD-aP, which was often treated with off-label therapies. Systematic reviews published in 2017-2020 identified GABA (gabapentin, pregabalin) analogues as having evidence for efficacy. This real-world study describes the prescription patterns for GABA over time and their frequency of use for CKD-aP.


Retrospective cohort study using administrative health data from Manitoba, Canada (>1.2 million residents). We included all adults (≥ 18 years) who received an incident prescription for a GABA between January 1st, 2012, and March 31st, 2022. We calculated the yearly prescription rate per new user for each GABA in total and for each of the following indications: neuropathy, seizure, fibromyalgia, restless legs syndrome (RLS), and chronic pain. Finally, we estimated the total and annual percentage of GABA prescribed for CKD-aP in the chronic dialysis population (defined as dialysis for 90 consecutive days with no gaps >15 days between sessions).


In the study period, there were 125,881 GABA analogue users (adults aged 18 and over). Gabapentin was more commonly prescribed (85%) than pregabalin (15%). The number of new GABA prescriptions increased from 11,301 in 2012 to 12,031 in 2021. Only 0.7% of these were prescribed to treat CKD-aP.
There were 4,028 chronic dialysis patients included. Indications for GABA prescriptions in this group were fibromyalgia (24%), seizures (12%), neuropathic pain (9%), RLS (10%) and CKD-aP (19%). Patients receiving GABA for CKD-aP were mostly men (57%) and were older (mean age 60 vs 56 years) than those in the general population. There was a decrease in the proportion of dialysis patients receiving GABA for CKD-aP from 2017 to 2020 (4% to 2.6%) with an increase in 2021 (4%).


GABA are rarely used for CKD-aP (0.7% of all GABA use), despite evidence of efficacy. We speculate that safety concerns may limit GABA use. Further studies of the risks:benefit of GABA analogues in CKD-aP are needed.


  • Commercial Support – Otsuka Canada Pharmaceutical Inc.