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Library · Brain & nerves · Chronic kidney disease-associated pruritus

Difelikefalin

Korsuva, CR845

Selective kappa opioid receptor agonist approved in 2021 as the first treatment for moderate-to-severe itching in adult hemodialysis patients with chronic kidney disease. Has over 10,000-fold greater affinity for kappa than mu opioid receptors, giving minimal brain effects.

Research score 83/100. Reference only, not a dose.

  • Pruritus Relief
  • Anti-itch
US status
Prescription Only
Approval
FDA Approved (2021)
Evidence
KALM-1 and KALM-2 Phase 3 trials demonstrated significant pruritus reduction vs placebo
Research score
83 / 100
Indication
CKD-associated pruritus in hemodialysis patients
Origin
United States
Source category
Pain & Analgesia
Status group
Approved / prescription

Mechanism

Activates kappa opioid receptors on peripheral sensory nerves and immune cells to dampen itch signaling, without central nervous system or mu-receptor involvement.

Safety file

Favorable profile; no respiratory depression, sedation, or euphoria, and low addiction potential.

  • Minimal due to peripheral action