Systematic Reviews and Meta Analysis
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The Effectiveness of Evidence-Based Aromatherapy Interventions in Uremic Pruritus

Year 2025, Volume: 20 Issue: 2, 115 - 124, 31.05.2025
https://doi.org/10.47565/ndthdt.2025.104

Abstract

Uremic pruritus is a common symptom observed in patients with end-stage renal disease undergoing dialysis treatment, impairing their quality of life. Due to the kidneys' inability to perform their functions, nitrogenous waste products accumulate in the body, leading to skin itching. The discomfort caused by itching, along with associated symptoms such as sleep disturbances, contributes to a deterioration in the overall quality of life. Although pharmacological treatments for uremic pruritus are available, their adverse pharmacodynamic and pharmacokinetic effects in patients with kidney disease make non-pharmacological approaches the preferred option for managing symptoms such as itching. Among Complementary and Integrative therapy methods, aromatherapy stands out as one of the most commonly used approaches due to its accessibility and ease of use. This article aims to discuss evidence-based aromatherapy practices for managing uremic pruritus and to discuss the findings of relevant studies. A literature review was conducted using the keywords “uremic pruritus,” “aromatherapy,” and “hemodialysis symptoms” in the MEDLINE, PUBMED, and DergiPark databases. After applying inclusion and exclusion criteria, 14 full-text studies were included in the review. The findings of the reviewed studies demonstrate that aromatherapy has a positive effect on uremic pruritus in patients undergoing dialysis.

References

  • Ateş K, Seyahi N, Koçyiğit İ. T.C. Sağlık Bakanlığı ve Türk Nefroloji Derneği Ortak Raporu 2023[Internet]. 2023[cited 2025 Jan 16]. Available from: https://nefroloji.org.tr/uploads/pdf/REGISTRY2023_web.pdf
  • Kılıç Akça, N, Taşçı, S, Karataş, N. Effect of acupressure on patients in Turkey receiving hemodialysis treatment for uremic pruritus. Altern Ther Health Med [Internet]. 2013[cited 2024 Aug 26];19(5):12-8. Available from: https://pubmed.ncbi.nlm.nih.gov/23981400/
  • Kavurmacı M, Tan M. Üremik kaşıntı ve aromaterapi uygulaması. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi [Internet]. 2014[cited 2024 Aug 20];3(1):674-82. Available from: https://dergipark.org.tr/tr/pub/gumussagbil/issue/7501/98885
  • Erdoğan Z, Atik DÖ. Çınar S. Kronik böbrek yetmezliğinde tamamlayıcı ve alternatif tıp yöntemlerinin kullanımı. AKTD [Internet]. 2014[cited 2024 Aug 26];23(4):773-89. Available from: https://dergipark.org.tr/tr/pub/aktd/issue/2202/29292
  • Kılıç Akça N, Taşcı S. Acupressure and transcutaneous electrical acupoint stimulation for ımproving uremic pruritus: A randomized, controlled trial. Altern Ther Health Med [Internet]. 2016[cited 2024 Aug 20];22(3):18-24. Available from: https://pubmed.ncbi.nlm.nih.gov/27228268/
  • Kılıç Akça N, Taşçı S. Kaşıntı kontrolünde kullanılan nonfarmakolojik yöntemler. Dermatoz [Internet]. 2012[cited 2024 Sep 12];3(3):108-113. Available from: https://dermatoz.org/articles/kasinti-kontrolunde-kullanilan-nonfarmakolojik- yontemler/doi/38393
  • Tseng YH. Aromatherapy in nursing practice. Hu Li Za Zhi J Nurs [Internet]. 2005[cited 2024 Sep 12];52(4):11–5. Available from: https://europepmc.org/article/MED/16088776#free-full-text
  • Yabacı S, Akça NK, Arslan DE. Kaşıntı-stres kısır döngüsü. ERÜ Sağlık Bilimleri Fakültesi Dergisi [Internet]. 2019[cited 2024 Sep 12];6(2):26-34. Available from: https://dergipark.org.tr/tr/pub/erusaglik/issue/52034/642496
  • Kuypers DR. Skin problems in chronic kidney disease. Nat Clin Pract Nephrol. 2009;5(3):157-70. doi: 10.1038/ncpneph1040.
  • Huang H, Wang Q, Guan X, Zhang X, Kang J, Zhang Y, et al. Effect of aromatherapy on preoperative anxiety in adult patients: A meta-analysis of randomized controlled trials. Complement Ther Clin Pract. 2021;42:101302. Doi: 10.1016/j.ctcp.2021.101302.
  • Pasupuleti SC, Hassan A. Evaluation of effectiveness of aromatherapy in managing anxious paediatric dental patient: An ın- Vivo study. J MARDS [Internet]. 2022[cited 2024 Aug 26];4(4):1-8. Available from: https://www.medicalandresearch.com/assets/articles/documents/DOCUMENT_20220131142716.pdf
  • Smith CA, Collins CT, Cyna AM, Crowther CA. Complementary and alternative therapies for pain management in labour. Cochrane Database Syst Rev. 2006;18(4):CD003521. doi: 10.1002/14651858.CD003521.pub2
  • Şar S, Kahya E, Ataç A. Aromaterapinin tarihçesi ve bu alanda kullanılan tıbbi bitkilerden örnekler. Lokman Hekim Dergisi [Internet]. 2011[cited 2024 Aug 26];32-3. Available from: https://dergipark.org.tr/tr/pub/mutftd/issue/46993/589939.
  • Herro E, Jacob SE. Mentha piperita (peppermint). Dermatitis [Internet]. 2010[cited 2024 Sep 12] 21(6): 327-9. Available from: https://pubmed.ncbi.nlm.nih.gov/21144345/
  • Shahgholian N, Dehghan M, Mortazavi M, Gholami F, Valiani M. Effect of aromatherapy on pruritus relief in hemodialysis patients. Iran J Nurs Midwifery Res [Internet]. 2010[cited 2024 Sep 12];15(4):240-4. Available from: https://pubmed.ncbi.nlm.nih.gov/22049288/
  • Bouya S, Ahmadidarehsima S, Badakhsh M, Balouchi A, Koochakzai M. Effect of aromatherapy interventions on hemodialysis complications: A systematic review. Complement Ther Clin Pract. 2018;(8)32:130-8. doi: 10.1016/j.ctcp.2018.06.008.
  • JBI Levels of evidence. Joanna Briggs Institue [Internet]. 2013[cited 2024 Aug 26]. Available from: https://jbi.global/sites/default/files/2019-05/JBI-Levels-of-evidence_2014_0.pdf
  • Karaçam Z. Sistematik derleme metodolojisi: sistematik derleme hazırlamak için bir rehber. DEUHYO ED [Internet]. 2013 [cited 2024 Aug 26];6(1):26–33. Available from: https://dergipark.org.tr/tr/pub/deuhfed/issue/46815/587078
  • Sarri G, Patorno E, Yuan H, Guo JJ, Bennett D, Wen X, et al. Framework for the synthesis of non-randomised studies and randomised controlled trials: a guidance on conducting a systematic review and meta-analysis for healthcare decision making. BMJ Evid Based Med. 2022;27(2):109-19. doi: 10.1136/bmjebm-2020-111493
  • Ha HC. Effect of aromatherapy on skin xerosis and pruritus in patients undergoing maintenance hemodialysis. J Korean Acad Nurs [Internet]. 1999[cited 2024 Aug 26];29(6):1284-93. Available from: https://www.koreamed.org/SearchBasic.php?RID=2378054
  • Ro YJ, Ha HC, Kim CG, Yeom HA. The effects of aromatherapy on pruritus in patients undergoing hemodialysis. Dermatol Nurs [Internet]. 2002[cited 2024 Aug 26];14(4):231-56. Available from: https://pubmed.ncbi.nlm.nih.gov/12240499/
  • Kang, SJ, Kim NY. The effects of aroma hand massage on pruritus, fatigue and stress of hemodialysis patients, J Korean Acad Nurs [Internet]. 2008 [cited 2024 Aug 26];20(6):883-94. Available from: https://koreamed.org/SearchBasic.php?RID=2290714
  • Jeong SK, Park HJ, Park BD, Kim IH. Effectiveness of topical chia seed oil on pruritus of end-stage renal disease (esrd) patients and healthy volunteers. Ann Dermatol. 2010;22(2):143-8. doi: 10.5021/ad.2010.22.2.143
  • Cürcani M, Tan M. The effect of aromatherapy on haemodialysis patients' pruritus. J Clin Nurs. 2014;23:3356– 65.https://doi.org/10.1111/jocn.12579
  • Yücel S. Üremik pruritus tedavisinde endokannabinoid içerikli nemlendirici kremlerin etkinliği [dissertation]. Başkent Üniversitesi Tıp Fakültesi; Uzmanlık Tezi, 2014.
  • Abdelghfar SZ, Elsebae HA, Elhadry SM, Hassan AA. Effect of aromatherapy on uremic pruritus among patients undergoing hemodialysis. IOSR-JNHS. 2017;6(2):22-30. doi: 10.9790/1959-0602082230
  • Afrasiabifar A, Mehri Z, Hosseini N. Efficacy of topical application of sweet almond oil on reducing uremic pruritus in hemodialysis patients: a randomized clinical trial study. IRCMJ. 2017;19(2):e34695. doi: 10.5812/ircmj.34695
  • Khoirot RMR, Kusnanto K, Suprajitno S. Effect of topical aromatherapy turmeric oil to pruritus scale on chronic kidney disease patients. Journal of Ners and Midwifery. 2019;6(3):396-400. doi:10.26699/jnk.v6i3.ART.p396-400
  • Khorsand A, Salari R, Noras MR, Saki A, Jamali J, Sharifipour F, et al. The effect of massage and topical violet oil on the severity of pruritus and dry skin in hemodialysis patients: A randomized controlled trial. Complement Ther Med. 2019;45:248- 53. doi: 10.1016/j.ctim.2019.06.015.
  • Menekli T, Durmaz YÇ. Effect of lavender aromatherapy on pruritus, anxiety, and sleep quality of patients undergoing hemodialysis: a randomized controlled trial. TMR Integr Nurs. 2021;5 (5):163–9. https://doi.org/10.53388/TMRIN2021163169
  • Sembiring F, Nasution SS, Ariani Y. The influence of peppermint aromatherapy on reducing uremic pruritus in patients with chronic kidney disease undergoing hemodialysis. Jurnal Keperawatan Soedirman. 2021;16(1). doi:10.20884/1.jks.2021.16.1.1273
  • Abbasi M, Mangolian Shahrbabaki P, Jahani Y, Mehdipour-Rabori R. The effect of topical chia oil and coconut oil on pruritus and laboratory parameters in hemodialysis patients. EBCJ. 2022;12(3):6-63. doi: 10.22038/EBCJ.2022.63945.2658
  • Seçkinli S. Hemşirelikte araştırma kullanımı ve kanıta dayalı uygulama. Erdoğan S, Nahcivan N, Esin N, eds. In:Hemşirelikte Araştırma Süreç, Uygulama ve Kritik. 4. Basım. Nobel Tıp Kitapevleri;2015.p.335-58.
  • Kocaman G. Hemşirelikte kanıta dayalı uygulama. Hemşirelikte Araştırma Geliştirme Dergisi. [Internet]. 2003[cited 2024 Sep 12];5(2):61-9. Available from: https://dergipark.org.tr/tr/pub/hemarge/issue/52683/694662
  • Güneş Ü. Hemşirelikte kanıta dayalı uygulama sürecinin adımları. Uluslararası Hakemli Hemşirelik Araştırmaları Dergisi. 2017;9:171-87. doi:10.17371/UHD2017.1.0006
  • Sarı M, Orhan F. Kanıt piramidi açısından en önemli araştırma yöntemi: meta-analiz. ASEAD [Internet]. 2019[cited 2024 Sep 12];6(8):70-88. Available from: https://dergipark.org.tr/tr/pub/asead/issue/49602/638011

Üremik Kaşıntıda Kanıt Temelli Aromaterapi Uygulamalarının Etkinliği/ The Effectiveness of Evidence-Based Aromatherapy Interventions in Uremic Pruritus

Year 2025, Volume: 20 Issue: 2, 115 - 124, 31.05.2025
https://doi.org/10.47565/ndthdt.2025.104

Abstract

Üremik kaşıntı, diyaliz tedavisi alan son dönem böbrek yetmezliği olan hastalarda sıklıkla görülen ve yaşam kalitesini azaltan bir semptomdur. Böbrekler fonksiyonlarını yerine getiremediği için vücutta biriken azotlu maddeler ciltte kaşıntıya neden olur. Kaşıntının neden olduğu huzursuzluk, uyku bozukluğu gibi rahatsız edici semptomlar, bireyin yaşam kalitesinde bozulmaya sebep olmaktadır. Üremik kaşıntıya yönelik farmakolojik tedaviler olsa da bunların böbrek hastaları üzerindeki farmakodinamik ve farmakokinetik dağılımlarının olumsuz sonuçları göz önüne alındığında; kaşıntı gibi semptomların kontrolünde nonfarmakolojik yöntemler tercih edilmektedir. Kişilerin kolay ulaşabilmesi ve rahat kullanımı sebebiyle aromaterapi, en sık kullanılan Tamamlayıcı ve İntegratif Tedavi yöntemleri arasındadır. Bu makalenin amacı; üremik kaşıntıda kullanılan kanıt temelli aromaterapi yöntemlerinin ve yapılan çalışmalarda elde edilen bulguların tartışılmasıdır. MEDLINE, PUBMED ve DergiPark veri tabanlarında “üremik kaşıntı”, “aromaterapi”, ve “hemodiyaliz semptomları” anahtar kelimeleri kullanılarak literatür taraması yapıldı. Tarama sonucunda dahil edilme ve dışlanma kriterlerinin uygulanmasının ardından tam metnine ulaşılabilen 14 araştırma, çalışmanın örneklemini oluşturdu. Taranan çalışmaların ortak sonucu, aromaterapinin diyaliz hastalarında görülen üremik kaşıntı üzerinde olumlu etkileri bulunduğu sonucuna varılmıştır.

References

  • Ateş K, Seyahi N, Koçyiğit İ. T.C. Sağlık Bakanlığı ve Türk Nefroloji Derneği Ortak Raporu 2023[Internet]. 2023[cited 2025 Jan 16]. Available from: https://nefroloji.org.tr/uploads/pdf/REGISTRY2023_web.pdf
  • Kılıç Akça, N, Taşçı, S, Karataş, N. Effect of acupressure on patients in Turkey receiving hemodialysis treatment for uremic pruritus. Altern Ther Health Med [Internet]. 2013[cited 2024 Aug 26];19(5):12-8. Available from: https://pubmed.ncbi.nlm.nih.gov/23981400/
  • Kavurmacı M, Tan M. Üremik kaşıntı ve aromaterapi uygulaması. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi [Internet]. 2014[cited 2024 Aug 20];3(1):674-82. Available from: https://dergipark.org.tr/tr/pub/gumussagbil/issue/7501/98885
  • Erdoğan Z, Atik DÖ. Çınar S. Kronik böbrek yetmezliğinde tamamlayıcı ve alternatif tıp yöntemlerinin kullanımı. AKTD [Internet]. 2014[cited 2024 Aug 26];23(4):773-89. Available from: https://dergipark.org.tr/tr/pub/aktd/issue/2202/29292
  • Kılıç Akça N, Taşcı S. Acupressure and transcutaneous electrical acupoint stimulation for ımproving uremic pruritus: A randomized, controlled trial. Altern Ther Health Med [Internet]. 2016[cited 2024 Aug 20];22(3):18-24. Available from: https://pubmed.ncbi.nlm.nih.gov/27228268/
  • Kılıç Akça N, Taşçı S. Kaşıntı kontrolünde kullanılan nonfarmakolojik yöntemler. Dermatoz [Internet]. 2012[cited 2024 Sep 12];3(3):108-113. Available from: https://dermatoz.org/articles/kasinti-kontrolunde-kullanilan-nonfarmakolojik- yontemler/doi/38393
  • Tseng YH. Aromatherapy in nursing practice. Hu Li Za Zhi J Nurs [Internet]. 2005[cited 2024 Sep 12];52(4):11–5. Available from: https://europepmc.org/article/MED/16088776#free-full-text
  • Yabacı S, Akça NK, Arslan DE. Kaşıntı-stres kısır döngüsü. ERÜ Sağlık Bilimleri Fakültesi Dergisi [Internet]. 2019[cited 2024 Sep 12];6(2):26-34. Available from: https://dergipark.org.tr/tr/pub/erusaglik/issue/52034/642496
  • Kuypers DR. Skin problems in chronic kidney disease. Nat Clin Pract Nephrol. 2009;5(3):157-70. doi: 10.1038/ncpneph1040.
  • Huang H, Wang Q, Guan X, Zhang X, Kang J, Zhang Y, et al. Effect of aromatherapy on preoperative anxiety in adult patients: A meta-analysis of randomized controlled trials. Complement Ther Clin Pract. 2021;42:101302. Doi: 10.1016/j.ctcp.2021.101302.
  • Pasupuleti SC, Hassan A. Evaluation of effectiveness of aromatherapy in managing anxious paediatric dental patient: An ın- Vivo study. J MARDS [Internet]. 2022[cited 2024 Aug 26];4(4):1-8. Available from: https://www.medicalandresearch.com/assets/articles/documents/DOCUMENT_20220131142716.pdf
  • Smith CA, Collins CT, Cyna AM, Crowther CA. Complementary and alternative therapies for pain management in labour. Cochrane Database Syst Rev. 2006;18(4):CD003521. doi: 10.1002/14651858.CD003521.pub2
  • Şar S, Kahya E, Ataç A. Aromaterapinin tarihçesi ve bu alanda kullanılan tıbbi bitkilerden örnekler. Lokman Hekim Dergisi [Internet]. 2011[cited 2024 Aug 26];32-3. Available from: https://dergipark.org.tr/tr/pub/mutftd/issue/46993/589939.
  • Herro E, Jacob SE. Mentha piperita (peppermint). Dermatitis [Internet]. 2010[cited 2024 Sep 12] 21(6): 327-9. Available from: https://pubmed.ncbi.nlm.nih.gov/21144345/
  • Shahgholian N, Dehghan M, Mortazavi M, Gholami F, Valiani M. Effect of aromatherapy on pruritus relief in hemodialysis patients. Iran J Nurs Midwifery Res [Internet]. 2010[cited 2024 Sep 12];15(4):240-4. Available from: https://pubmed.ncbi.nlm.nih.gov/22049288/
  • Bouya S, Ahmadidarehsima S, Badakhsh M, Balouchi A, Koochakzai M. Effect of aromatherapy interventions on hemodialysis complications: A systematic review. Complement Ther Clin Pract. 2018;(8)32:130-8. doi: 10.1016/j.ctcp.2018.06.008.
  • JBI Levels of evidence. Joanna Briggs Institue [Internet]. 2013[cited 2024 Aug 26]. Available from: https://jbi.global/sites/default/files/2019-05/JBI-Levels-of-evidence_2014_0.pdf
  • Karaçam Z. Sistematik derleme metodolojisi: sistematik derleme hazırlamak için bir rehber. DEUHYO ED [Internet]. 2013 [cited 2024 Aug 26];6(1):26–33. Available from: https://dergipark.org.tr/tr/pub/deuhfed/issue/46815/587078
  • Sarri G, Patorno E, Yuan H, Guo JJ, Bennett D, Wen X, et al. Framework for the synthesis of non-randomised studies and randomised controlled trials: a guidance on conducting a systematic review and meta-analysis for healthcare decision making. BMJ Evid Based Med. 2022;27(2):109-19. doi: 10.1136/bmjebm-2020-111493
  • Ha HC. Effect of aromatherapy on skin xerosis and pruritus in patients undergoing maintenance hemodialysis. J Korean Acad Nurs [Internet]. 1999[cited 2024 Aug 26];29(6):1284-93. Available from: https://www.koreamed.org/SearchBasic.php?RID=2378054
  • Ro YJ, Ha HC, Kim CG, Yeom HA. The effects of aromatherapy on pruritus in patients undergoing hemodialysis. Dermatol Nurs [Internet]. 2002[cited 2024 Aug 26];14(4):231-56. Available from: https://pubmed.ncbi.nlm.nih.gov/12240499/
  • Kang, SJ, Kim NY. The effects of aroma hand massage on pruritus, fatigue and stress of hemodialysis patients, J Korean Acad Nurs [Internet]. 2008 [cited 2024 Aug 26];20(6):883-94. Available from: https://koreamed.org/SearchBasic.php?RID=2290714
  • Jeong SK, Park HJ, Park BD, Kim IH. Effectiveness of topical chia seed oil on pruritus of end-stage renal disease (esrd) patients and healthy volunteers. Ann Dermatol. 2010;22(2):143-8. doi: 10.5021/ad.2010.22.2.143
  • Cürcani M, Tan M. The effect of aromatherapy on haemodialysis patients' pruritus. J Clin Nurs. 2014;23:3356– 65.https://doi.org/10.1111/jocn.12579
  • Yücel S. Üremik pruritus tedavisinde endokannabinoid içerikli nemlendirici kremlerin etkinliği [dissertation]. Başkent Üniversitesi Tıp Fakültesi; Uzmanlık Tezi, 2014.
  • Abdelghfar SZ, Elsebae HA, Elhadry SM, Hassan AA. Effect of aromatherapy on uremic pruritus among patients undergoing hemodialysis. IOSR-JNHS. 2017;6(2):22-30. doi: 10.9790/1959-0602082230
  • Afrasiabifar A, Mehri Z, Hosseini N. Efficacy of topical application of sweet almond oil on reducing uremic pruritus in hemodialysis patients: a randomized clinical trial study. IRCMJ. 2017;19(2):e34695. doi: 10.5812/ircmj.34695
  • Khoirot RMR, Kusnanto K, Suprajitno S. Effect of topical aromatherapy turmeric oil to pruritus scale on chronic kidney disease patients. Journal of Ners and Midwifery. 2019;6(3):396-400. doi:10.26699/jnk.v6i3.ART.p396-400
  • Khorsand A, Salari R, Noras MR, Saki A, Jamali J, Sharifipour F, et al. The effect of massage and topical violet oil on the severity of pruritus and dry skin in hemodialysis patients: A randomized controlled trial. Complement Ther Med. 2019;45:248- 53. doi: 10.1016/j.ctim.2019.06.015.
  • Menekli T, Durmaz YÇ. Effect of lavender aromatherapy on pruritus, anxiety, and sleep quality of patients undergoing hemodialysis: a randomized controlled trial. TMR Integr Nurs. 2021;5 (5):163–9. https://doi.org/10.53388/TMRIN2021163169
  • Sembiring F, Nasution SS, Ariani Y. The influence of peppermint aromatherapy on reducing uremic pruritus in patients with chronic kidney disease undergoing hemodialysis. Jurnal Keperawatan Soedirman. 2021;16(1). doi:10.20884/1.jks.2021.16.1.1273
  • Abbasi M, Mangolian Shahrbabaki P, Jahani Y, Mehdipour-Rabori R. The effect of topical chia oil and coconut oil on pruritus and laboratory parameters in hemodialysis patients. EBCJ. 2022;12(3):6-63. doi: 10.22038/EBCJ.2022.63945.2658
  • Seçkinli S. Hemşirelikte araştırma kullanımı ve kanıta dayalı uygulama. Erdoğan S, Nahcivan N, Esin N, eds. In:Hemşirelikte Araştırma Süreç, Uygulama ve Kritik. 4. Basım. Nobel Tıp Kitapevleri;2015.p.335-58.
  • Kocaman G. Hemşirelikte kanıta dayalı uygulama. Hemşirelikte Araştırma Geliştirme Dergisi. [Internet]. 2003[cited 2024 Sep 12];5(2):61-9. Available from: https://dergipark.org.tr/tr/pub/hemarge/issue/52683/694662
  • Güneş Ü. Hemşirelikte kanıta dayalı uygulama sürecinin adımları. Uluslararası Hakemli Hemşirelik Araştırmaları Dergisi. 2017;9:171-87. doi:10.17371/UHD2017.1.0006
  • Sarı M, Orhan F. Kanıt piramidi açısından en önemli araştırma yöntemi: meta-analiz. ASEAD [Internet]. 2019[cited 2024 Sep 12];6(8):70-88. Available from: https://dergipark.org.tr/tr/pub/asead/issue/49602/638011
There are 36 citations in total.

Details

Primary Language Turkish
Subjects ​Internal Diseases Nursing​
Journal Section Article
Authors

Nilhan Töyer Şahin 0000-0001-7804-4183

Seda Pehlivan 0000-0002-1670-0672

Publication Date May 31, 2025
Submission Date November 27, 2024
Acceptance Date February 17, 2025
Published in Issue Year 2025 Volume: 20 Issue: 2

Cite

Vancouver Töyer Şahin N, Pehlivan S. Üremik Kaşıntıda Kanıt Temelli Aromaterapi Uygulamalarının Etkinliği/ The Effectiveness of Evidence-Based Aromatherapy Interventions in Uremic Pruritus. JoNN. 2025;20(2):115-24.

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