Chronic Kidney Disease-Associated Pruritus Is Linked to Selective Enrichment of Taurine-Conjugated Bile Acid Subspecies

Düll M, Rauh M, Dietrich P, Vetter M, Schmid J, Mettang T, Kremer A (2026)

Publication Type: Journal article

Publication year: 2026

Journal

JEADV Clinical Practice Wiley

DOI: 10.1002/jvc2.70447

Abstract

Background: Chronic kidney disease-associated pruritus (CKDaP) is a common and debilitating symptom in patients with advanced renal disease. The underlying pathophysiology of CKDaP remains poorly understood, but dysregulation of bile acid metabolism has been suggested as a contributing factor. Objectives: This study aimed to investigate systemic bile acid parameters in CKDaP patients compared to haemodialysis-dependent CKD patients without pruritus, to identify potential metabolic differences. Methods: We conducted a cross-sectional case-control study analysing clinical and laboratory data and performed targeted metabolomic profiling of major bile acid subspecies, including their taurine and glycine conjugates, using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Additionally, we measured serum fibroblast growth factor 19 (FGF-19) levels in a well-defined cohort of CKD patients on haemodialysis, with (n = 20) and without pruritus (n = 20). Results: Despite no significant differences in clinical and routine laboratory parameters between the groups, CKDaP patients exhibited a significantly lower glycine-to-taurine-conjugated bile acid ratio compared to non-pruritic patients, primarily due to elevated levels of taurine-conjugated bile acids. Limitations: The small sample size, cross-sectional design and single-time-point assessments limit causal inference and the generalizability of the findings. Conclusions: Alterations in the conjugated bile acid profile, particularly an increased taurine conjugation, may play a role in the pathogenesis of CKDaP.

Authors with CRIS profile

Miriam Düll Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology Manfred Rauh Department of Paediatrics and Adolescent Medicine Peter Dietrich Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology Marcel Vetter Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology Jonas Schmid Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology Andreas Kremer Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology

Involved external institutions

HELIOS Kliniken DE Germany (DE)

How to cite

APA:

Düll, M., Rauh, M., Dietrich, P., Vetter, M., Schmid, J., Mettang, T., & Kremer, A. (2026). Chronic Kidney Disease-Associated Pruritus Is Linked to Selective Enrichment of Taurine-Conjugated Bile Acid Subspecies. JEADV Clinical Practice. https://doi.org/10.1002/jvc2.70447

MLA:

Düll, Miriam, et al. "Chronic Kidney Disease-Associated Pruritus Is Linked to Selective Enrichment of Taurine-Conjugated Bile Acid Subspecies." JEADV Clinical Practice (2026).

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