Cutaneous Alterations in Patients with Chronic Renal Failure
Jorge L Sanchez1992, International Journal of Dermatology
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Abstract
The purpose of this study was to evaluate the prevalence of dermatologic problems among patients witb chronic renal failure (CRF) undergoing hemodialysis or peritoneal dialysis. One-hundred and two patients witb CRF were examined for the presence of cutaneous alterations. All patients examined bad at least one cutaneous lesion. Tbe most prevalent findings were alterations in the cutaneous pigmentation. Of particular interest was an increased prevalence of hyperpigmented macules on the palms and soles. Otber manifestations, seen particularly in the hemodialysis group, included the balf-and-balf nail, pruritus, and keratotic pits of tbe palms and soles. Infectious processes were more prevalent in tbe group undergoing peritoneal dialysis. This study sbowed tbat all patients witb CRF have some type of cutaneous alteration and that the type of dialysis could have some influence upon the incidence of tbese changes.
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Cutaneous abnormalities in patients with end stage renal failure on chronic hemodialysis. A study of 458 patients
Journal of Dermatological Case Reports, 2014
Background: Cutaneous manifestations occurring in patients with end stage renal failure on hemodialysis are polymorphic and diverse. Objective: The aim of our study was to assess the prevalence and characteristics of different cutaneous manifestations in patients on hemodialysis. Patients and methods: We led a transverse investigation of all patients on hemodialysis in 12 haemodialysis centres of Sfax (Tunisia). We examined 458 patients (254 men and 204 women). The hemodialysis history ranged from 6 months to 24 years. A total of 394/458 (86%) patients had cutaneous abnormalities. These included pruritus (56.6% of patients), paleness (60.7%), xerosis (52.8%), hyperpigmentation or hypopigmentation (38.4%), venous dilation near the fistula (22.2%), eczema in the fistula area (14.8%), half-and-half nails (13.5%), onychodystrophy (6.1%), subungual hemorrhage (4.5%), leukonychia (4.5%), stomatitis (5.6%), xerostomia (3.2%), gingivitis (2.4%), uremic breath (2.1%), and skin calcificatins (0.4%). Nephrogenic fibrosing dermopathy was not detected in any of our patients. Conclusion: Pruritus, paleness, dry skin as well as hyperpigmentation and hypopigmentation are the most frequent skin abnormalities observed in hemodialysis patients. The early recognition of some cutaneous conditions associated with end stage renal failure and hemodialysis may allow early therapeutic intervention and decrease morbidity.
Cutaneous manifestations in patients with chronic renal failure on hemodialysis
Indian Journal of Dermatology, Venereology and Leprology, 2006
Background: Chronic renal failure (CRF) presents with an array of cutaneous manifestations. Newer changes are being described since the advent of hemodialysis, which prolongs the life expectancy, giving time for these changes to manifest. Aim: The aim of this study was to evaluate the prevalence of dermatologic problems among patients with chronic renal failure (CRF) undergoing hemodialysis. Methods: One hundred patients with CRF on hemodialysis were examined for cutaneous changes. Results: Eighty-two per cent patients complained of some skin problem. However, on examination, all patients had at least one skin lesion attributable to CRF. The most prevalent finding was xerosis (79%), followed by pallor (60%), pruritus (53%) and cutaneous pigmentation (43%). Other cutaneous manifestations included Kyrle's disease (21%); fungal (30%), bacterial (13%) and viral (12%) infections; uremic frost (3%); purpura (9%); gynecomastia (1%); and dermatitis (2%). The nail changes included half and half nail (21%), koilonychia (18%), onychomycosis (19%), subungual hyperkeratosis (12%), onycholysis (10%), splinter hemorrhages (5%), Mees' lines (7%), Muehrcke's lines (5%) and Beau's lines (2%). Hair changes included sparse body hair (30%), sparse scalp hair (11%) and brittle and lusterless hair (16%). Oral changes included macroglossia with teeth markings (35%), xerostomia (31%), ulcerative stomatitis (29%), angular cheilitis (12%) and uremic breath (8%). Some rare manifestations of CRF like uremic frost, gynecomastia and pseudo-Kaposi's sarcoma were also observed. Conclusions: CRF is associated with a complex array of cutaneous manifestations caused either by the disease or by treatment. The commonest are xerosis and pruritus and the early recognition of cutaneous signs can relieve suffering and decrease morbidity.
" Cutaneous manifestations in chronic renal failure patients on haemodialysis "
Introduction: Chronic renal failure presents with wide range of cutaneous manifestations. Many newer changes have been described since the advent of haemodialysis which prolongs the life expectancy giving time for these changes to manifest. Aims & Objectives: To find the array of various dermatological conditions that can occur in patients of CRF on haemodialysis. Materials and Methods: A total 100 patients with chronic renal failure on haemodialysis and having at least single cutaneous manifestation was included in the study. Results: Of the total 82% of the patients complained of certain skin problems however on examination all patients had at least one skin problem attributable to chronic renal failure. The most prevalent finding among them was Xerosis (52%), Pruritus (32%), Diffuse cutaneous hyperpigmentation (22%), Kyrle's disease (71%) of the total of acquired reactive perforating dermatosis(7%), Fungal infections (16%), Bacterial infections (10%) and Viral in (10%), Purpura (3%) and other Dermatosis (13%).The nail changes observed were Half and Half nails (20%), Koilonychia (18%), Onychomycosis (15%), Sub-ungual hyperkeratosis (8%), Beaus lines (2%) .Hair changes were sparse body hair (10%), dry lustreless hair (4%), and sparse scalp hair (10%). Oral changes observed were Ulcerative stomatitis (29%), Angular chelitis (12%. Other manifestations of CRF observed were like gynaecomastia, psuedokaposis sarcoma, and nephrogenic fibrosing dermopathy. Conclusion: CRF is associated with a complex array of cutaneous manifestations caused either by the disease or by the treatment. The early recognition of cutaneous signs can relieve suffering and decrease morbidity.
Cutaneous changes in chronic kidney disease patients on maintenance hemodialysis visiting at tertiary care hospital, Karachi
Journal of Pakistan Association of Dermatologists 2014;24 (2):156-159, 2014
Objective To determine the frequency of cutaneous changes in patients with chronic kidney disease on maintenance hemodialysis. Methods A cross-sectional study conducted A total of 100 patients with chronic kidney disease on maintenance hemodialysis were included. After taking demographic data, cutaneous changes were noted. Mean and standard deviation were computed for quantitative variables (age) and frequency and percentage were computed for categorical variable (sex, cutaneous changes). Results Mean age was 52.58±13.84 years and out of 100 patients 56% were males. At least one skin change was noted in 91%. Among type of manifestations, xerosis was noted in 96%, generalized xerosis 70%, alopecia 70%, half-and-half nails 36%, scaling 20% and ichthyosis 10%. Pruritus was found in 64%, out of these 93% had mild to moderate intensity and 7% had severe intensity of pruritus. Conclusion Chronic kidney disease is associated with a complex array of cutaneous manifestations caused either by the disease or by treatment. Xerosis and pruritus were most common among patients with CKD, so early recognition of cutaneous signs can relieve suffering and decrease morbidity.
Skin lesions in chronic renal dialysis
Jornal Brasileiro de Nefrologia, 2014
Cutaneous and mucosal disorders are the most common problems in patients on long-term hemodialysis. The dialysis prolongs the life expectancy, giving time of these changes to manifest. The aim of this study was to evaluate the prevalence of dermatologic problems among patients with chronic renal disease (CRD) undergoing hemodialysis. Methods: One hundred forty-five patients with chronic renal disease undergoing hemodialysis were studied. All patients were thoroughly examined for skin changes, hair, nails and mucous membranes by a single examiner and laboratory tests were assessed. The data were stored in a database Microsoft Excel and analyzed using descriptive statistics. The continuous variables were compared using Student's t-test and categorical variables the chi-square test or Fisher's Exact test. Results: The study included 145 patients, mean age of 53.6 ± 14.7 years, predominantly male (64.1%) and caucasian (90.0%). The average time of dialysis was 43.3 ± 42.3 months. The main underlying diseases were: hypertension in 33.8%, diabetes mellitus in 29.6% and chronic glomerulonephritis in 13.1% of the patients. The main dermatologic manifestations observed were: xerosis in 109 (75.2%), ecchymosis in 87 (60.0%), pruritus in 78 (53.8%) and lentigo in 33 (22.8%) patients. Conclusion: Our study showed the presence of more than one alteration per patient. Cutaneous alterations are frequent in patients on dialysis. Further studies are needed to better characterization and management of these dermatosis.
Diagnosis of Common Dermopathies in Dialysis Patients: A Review and Update
Seminars in Dialysis, 2012
Cutaneous abnormalities in patients with end-stage renal disease (ESRD) receiving hemodialysis or peritoneal dialysis may demonstrate signs of their underlying condition or reveal associated disease entities. While a thorough examination of the scalp, skin, mucosa, and nails is integral to establishing a diagnosis, certain conditions will resolve only with dialysis or improvement of their renal disease and others may not require or respond to treatment. Half and half nails, pruritus, xerosis, and cutaneous hyperpigmentation are common manifestations in ESRD. With hemodialysis, uremic frost is no longer prevalent in ESRD patients and ecchymo-ses have decreased in incidence. Acquired perforating dermatoses are seen in over one-tenth of hemodialysis patients. Metastatic calcinosis cutis and calciphylaxis are both rarely reported, although the latter is seen almost exclusively in the setting of hemodialysis. Diagnosis of nephrogenic systemic fibrosis has historically been challenging; as such, new diagnostic criteria have been proposed. Blood porphyrin profiles are needed to differentiate between porphyria cutanea tarda and pseudoporphyria. We will review and provide an update on the aforementioned common cutaneous manifestations of ESRD in patients receiving dialysis.
Report: Cutaneous disorders in uremic patients on hemodialysis: an Egyptian case‐controlled study
International journal of …, 2010
Background We studied the prevalence of mucocutaneous disorders in uremic adults and children on hemodialysis (HD) vs. controls, in Egypt. Methods A total of 206 Egyptians with uremia (163 adults and 43 children) undergoing HD, and 199 healthy controls (161 adults and 38 children), were examined for mucocutaneous abnormalities. Results Specific cutaneous diseases associated with renal insufficiency were found in five adults, including acquired perforating dermatosis and pseudo-porphyria. Non-specific abnormalities included xerosis (54%), pallor (42.2%), nail changes (34.9%), hair changes (34%), pruritus (32%), hyper-pigmentation (22.2%), coated tongue (14.1%), ecchymosis (1.5%), and gingival hypertrophy (1.5%). Disorders found significantly more often in uremics than controls included pallor, nail changes, hair changes, pruritus, hyperpigmentation and coated tongue in adults (P < 0.05), and nail changes, hair changes, and hyper-pigmentation in children (P < 0.05). The prevalence of each mucocutaneous abnormality was similar in uremic adults and children except for pallor [more common in adults (P = 0.001)], and hyper-pigmentation [more common in children (P = 0.003)]. A greater number of hepatitis C virus-positive than-negative adult uremics had hyper-pigmentation (P < 0.05), and more diabetic uremics had pruritus than did non-diabetics (P < 0.05). Conclusion Mucocutaneous disorders occur in adults and children with uremia, some of which are specific associations with the underlying renal disease. Occurrence of some of the non-specific abnormalities, such as xerosis, ecchymosis, and gingival hypertrophy, may be coincidental or associated with factors other than renal insufficiency.
Dermatological Manifestations in Patients of Chronic Kidney Disease
Background:Chronic kidney disease is a pathophysiologic process with multiple aetiologies, resulting in the inexorable attrition of nephron number and function, and frequently leading to end stage renal disease (ESRD). There are diverse ways in which the skin is affected by chronic kidney disease (CKD). Various specific and nonspecific skin abnormalities are observed in the patients which are caused either by the disease or by treatment and is due tofactors ranging from metabolic disturbances to immunosuppressive drugs. Objective: To study and compare the various dermatological manifestations seen in patients suffering from chronic kidney disease. Materials and methods: This study was carried out in P.G. Department of Medicine, Sarojini Naidu Medical College, Agra over a period of 18 months. 120 patients attending the outpatient and inpatient department of medicine fulfilling the inclusion and exclusion criteria were selected. Result: A significant percentage of patients suffering from chronic kidney disease in both group A and B were found to have dermatological manifestations. Conclusion: Dermatological manifestations in chronic kidney disease patients in in our study was significantly associated with mean duration of disease, which was higher in dialytic patients as compared to non-dialytic patients.
A Clinical Study of Cutaneous Manifestations of Chronic Kidney Disease
Journal of Evolution of Medical and Dental Sciences, 2016
BACKGROUND The kidneys and the skin are two important organs whose blood supply far exceeds their demand, the former for maintaining the milieu interior and the latter for rendering man homoeothermic. Changes of the skin are frequently seen in patients with kidney disease and in those who are undergoing dialysis. A number of diseases are characterised by distinctive cutaneous and renal manifestations. MATERIALS AND METHODS This study spanned a course of 6 months from January 2011 to June 2011. During this period 82 patients admitted in the Nephrology ward of Osmania General Hospital for dialysis as well as those patients referred to the Dermatology Outpatient Department from the Nephrology Department were screened for evidence of cutaneous manifestations of kidney disease. Of these, 50 patients who had the presence of skin manifestations were selected and studied, both sexes and all age groups were included in the study. RESULTS Out of 50 patients in the age group of 1-70 years, (66%) maximum number of patients were observed between 3rd to 5th decade while least number in 1st and 2nd decade. Youngest Patient studied-Male, 7 Years. Oldest patient studied-Male, 69 Years. Xerosis or dryness of the skin was seen in 28 patients. 14 patients out 50 showed pallor. Pruritus was seen in 12 patients. Purpura was seen in 3 patients. Perforating dermatoses was seen in 3 patients. Fungal infections were seen in 9 patients. Bacterial infections were seen in 5 patients. Viral infections were seen in 4 patients. Scabies was seen in 2 patients. Sparse scalp hair was reported in 7. Specific nail changes were seen in 19 patients. CONCLUSIONS Among the various cutaneous manifestations, xerosis and pigmentary changes topped the list of prevalence with Xerosis 56%, Pallor 28%. Pruritus was seen in 24% of patients. Nearly, 6% had perforating dermatosis. The Prevalence of hair abnormalities in our study was 14%. Prevalence of nail changes were seen in 38% of cases. Cutaneous infections were seen in 36% of patients.
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Prospective study on prevalence of dermatological changes in patients under hemodialysis in hemodialysis units in Tanta University hospitals, Egypt
Clinical, Cosmetic and Investigational Dermatology, 2014
Chronic hemodialysis patients experience frequent and varied mucocutaneous manifestations in addition to hair and nail disorders. The aim of this study was to evaluate the prevalence of dermatological changes among patients with end-stage renal disease under hemodialysis in a hemodialysis unit in Tanta University hospitals over a period of 6 months, and to evaluate the relations of these dermatological disorders with the duration of hemodialysis as well as with different laboratory parameters in these patients. Patients and methods: Ninety-three patients with end-stage renal disease on regular hemodialysis (56 males and 37 females) were selected and included in this cross-sectional, descriptive, analytic study. Their ages ranged from 18-80 years. All patients underwent thorough general and dermatological examinations. Laboratory investigations (complete blood counts, renal and liver function tests, serum parathormone levels, serum electrolytes, alkaline phosphatase, random blood sugar, and Hepatitis C virus (HCV) antibodies) were evaluated. Results: This study revealed that most patients had nonspecific skin changes, including xerosis, pruritus, pallor, ecchymosis, hyperpigmentation, and follicular hyperkeratosis. Nail and hair changes were commonly found, especially half and half nail, koilonychia, subungal hyperkeratosis, melanonychia, onychomycosis, and brittle and lusterless hair. Mucous membrane changes detected were pallor, xerostomia, macroglossia, bleeding gums, aphthous stomatitis, and yellow sclera. There was a significant positive correlation between the presence of pruritus and serum parathormone level. There was a significant negative correlation between the presence of mucous membrane changes and hemoglobin level. Conclusion: Nonspecific mucocutaneous manifestations are common in patients on hemodialysis, particularly xerosis, dyspigmentation, and pruritus. Early and prompt recognition and treatment of dermatological conditions in patients on dialysis may improve their quality of life.
Cutaneous Manifestations in Egyptian Patients with Chronic Renal Failure on Regular Hemodialysis
2015
Background. Hemodialysis patients experience frequent and various cutaneous manifestations of often hypothetical pathogenesis. Chronic renal failure (CRF) presents with an array of cutaneous manifestations. Objective. To evaluate the prevalence and nature of cutaneous lesions, associated with CRF patients on hemodialysis in Egyptian patients. Patients and methods. One hundred patients with CRF on regular hemodialysis from nephrology units were examined for cutaneous changes. Specific investigations like skin biopsy, culture and sensitivity for bacterial infections, potassium hydroxide mount and fungal culture were done when indicated. Results. All patients included in this study had at least one cutaneous manifestation attributable to CRF. The most prevalent findings was pruritus (55%), followed by xerosis (54%), hyperpigmentation (54%) and pallor (45%). Other cutaneous manifestations were wrinkles (40%), fungal infections (33%), ecchymosis (27%), dermatitis (23%), yellow face (22%)...
A clinical study of cutaneous and mucosal manifestations in patients with chronic renal failure on hemodialysis
International Journal of Research in Dermatology, 2017
INTRODUCTION Chronic kidney disease (CKD) is defined as presence of kidney damage, manifested by abnormal albumin excretion or decreased kidney function, quantified by measured or estimated glomerular filtration rate (GFR) that persists for more than 3 months. Chronic kidney disease is major health problem. Hemodialysis is the standard treatment for these patients. Chronic kidney failure presents with an array of cutaneous manifestations. The number of CKD patients continue to rise, reflecting growing elderly population and increasing numbers of patients with diabetes and hypertension. 1 Hence we undertook this study to analyse the pattern of cutaneous manifestation in patients with CKD on hemodialysis in our population. METHODS Patient attending Dermatology and Nephrology OPD of Sri Manakula Vinayagar Medical College & Hospital with chronic renal failure from November 2014 to May 2016 was included in the study. After getting informed consent a detailed history of the patient and examination was entered in a pre-prepared proforma. The demographic characteristics were recorded and the ABSTRACT Background: Chronic kidney disease is defined as presence of kidney damage, manifested by abnormal albumin excretion or decreased kidney function, quantified by measured or estimated glomerular filtration rate (GFR) that persists for more than 3 months. Chronic kidney disease is major health problem. Chronic kidney failure presents with an array of cutaneous manifestations. The objective of the present study was to determine the pattern of mucocutaneous manifestations of chronic renal failure on hemodialysis. Methods: A cross sectional study done in the Dermatology & Nephrology OPD of Sri Manakula Vinayagar Medical College and Hospital from October 2014 to May 2016. About 38 consenting patients who fulfilled the inclusion criteria were chosen for the study. The demographic characteristics were included in the study and the clinical profile of the patient such as hematological investigation and renal function tests were assessed. KOH mount, skin biopsy, Woods lamp, Grams stain and culture & sensitivity were done if needed after getting informed consent from the patients. Results: The most common cutaneous manifestations in haemodialysis patients were xerosis and uraemic pruritus. Conclusions: Cutaneous manifestations like uraemic pruritus, Xerosis, Kyrle's disease, infections, icthyosis & other lesions were seen with Xerosis beimg the most common feature. At least one cutaneous manifestation is found in all CRF patients.
Comparative study of cutaneous manifestations in patients with chronic kidney disease , patients on haemodialysis, and renal transplant recipients
Journal of Pre-Clinical and Clinical Research
Introduction. A wide variety of skin diseases occur in patients with chronic renal failure (CRF). These diseases are either related to the underlying chronic kidney disease (CKD) or to its treatment modalities like hemodialysis (HD) and renal transplant (RT). The studies comparing cutaneous manifestations in CKD, CKD with HD and RT recipients (RTR's) have been limited. Material and methods. 106 patients with CKD, 101 patients with CKD and who are undergoing HD and 80 RTR's having at least one dermatological complaint formed the study groups. Detailed cutaneous examination was done for all patients and dermatological manifestations were compared among various study groups. Results. The most prevalent finding in CKD patients was xerosis (69%) followed by pruritus (67%) and pigmentation disorders (11%). Other cutaneous manifestations included acquired perforating diseases(APD) (7.5%); fungal (9.4%), viral (7%) and bacterial (2%) infections and nail changes(11%).The manifestations found in CKD patients on HD were xerosis (65%) followed by pruritus (62%),pigmentation disorders (20%), APD (6%); fungal (9.9%), viral (4%) and bacterial (5%) infections and nail changes(19%). In RTR's, however, infections (47%) were the most prevalent finding. Others were xerosis(20%), pruritis(9%),pigmentation disorders(5%),APD (1%),nail changes(5%) and lesions of aesthetic interest(14%). Manifestations like pruritus, xerosis, hyperpigmentation and infections differed significantly when compared amongst three groups. Conclusions. Cutaneous manifestations are common and different in CKD, HD and RTR group of patients. While xerosis and pruritus were common in CKD and HD group, infections were most prevalent in RTRs.
Dermatologic Manifestations in End Stage Renal Disease Patients on Maintenance Hemodialysis
IOSR Journals , 2019
Background: End Stage Renal Disease(ESRD) presents with an array of cutaneous manifestations. Newer changes are being described since the advent of hemodialysis, which prolongs the life expectancy, giving time for these changes to manifest. Aim: The aim of this study was to evaluate the prevalence of dermatologic problems among patients with End Stage Renal Disease (ESRD) undergoing hemodialysis. Methods: One hundred patients with ESRD on hemodialysis were examined for cutaneous changes. Results: Eighty-two per cent patients complained of some dermatologic problem. However, on examination, all patients had atleast one skin lesion attributable to ESRD. The most prevalent finding was xerosis(79%), followed by pallor(60%), pruritus(53%) and skin pigmentation(43%).other dermatologic manifestations include Kyrle’s disease (21%), fungal (30%), bacterial (13%) and viral (12%) infections; uremic frost (3%), purpura (9%), gynecomastia (1%);and dermatitis (2%). The nail changes included half and half nail (21%), koilonychia (18%), onychomycosis (19%), subungual hyperkeratosis (12%), onycholysis (10%), splinter hemorrhages (5%), Mees' lines (7%), Muehrcke's lines (5%) and Beau's lines (2%). Hair changes included sparse body hair (30%), sparse scalp hair (11%) and brittle and lusterless hair (16%). Oral changes included macroglossia with teeth markings (35%), xerostomia (31%), ulcerative stomatitis (29%), angular cheilitis (12%) and uremic breath (8%). Some rare manifestations of ESRD like uremic frost, gynecomastia and pseudo-Kaposi's sarcoma were also observed. Conclusions: ESRD is associated with a complex array of cutaneous manifestations caused either by the disease or by treatment. The commonest are xerosis and prutitus and the early recognition of dermatologic manifestations can relieve suffering and decrease morbidity.
A clinical study of cutaneous manifestations in patients with chronic kidney disease
2015
Background: Skin is often considered as a mirror of internal diseases. Many systemic diseases produce cutaneous manifestations before or after the onset of systemic events. Patients with Chronic Kidney Disease (CKD) are often burdened by skin lesions, these findings can prompt for early diagnosis of CKD and its management. Material & Methods: A total of 150 cases of CKD with or without hemodialysis were studied for a period of 18 months. Detailed cutaneous examination was done and dermatological manifestations were evaluated and compared among dialysis and pre-dialysis groups. Results: 97 patients were in Dialysis group and 53 in Pre-dialysis group. Xerosis(62%)was most common followed by pallor(31.3%), pruritus (28%), pigmentation (25%), infections (13.3%), purpura & ecchymoses(12.7%), absent lunula(11%), xerostomia (11%), eczema(9.3%), leukonychia (8%), perforating disorders(7.3%), half & half nails (7%). Bullous disorders and nephrogenic systemic fibrosis were encountered less of...
Skin manifestations in end stage renal disease patients on hemodialysis
The Professional Medical Journal, 2019
Chronic kidney disease (CKD) is a world public health problem that is related with high morbidity and mortality. CKD patients can present with different skin manifestations, often benign with much impact on quality of patients life. Study Design: Case-series study. Setting: Nephrology Unit Civil Hospital Larkana. Period: From 1st January 2018 to 30th June 2018. Material and methods: 141 patients of ESRD on regular HD for at least 1 month. Patients were chosen randomly for evaluation of cutaneous changes regardless of their gender, age, sex and etiology of ESRD. General and dermatological examination of the skin, hair, nails, and oral mucosa was performed by consultant dermatologist. Data were analyzed by using IBM SPSS version 23.0. Descriptive analyses performed using mean with standard deviation and median with inter quartile ranges of quantitative data set. Count and percentages were reported for categorical data set. Results: In the present study there were one hundred and forty...
CUTANEOUS MANIFESTATIONS IN CHRONIC RENAL DISEASE – An observational study of skin changes, new findings, their association with hemodialysis, and their correlation with severity of CKD
Chronic Kidney Disease (CKD) is associated with various cutaneous abnormalities caused either by the disease or by treatment and can precede or follow initiation of dialysis, significantly impairing the quality of life in individuals. This study was undertaken to study the variety and prevalence of cutaneous manifestations in chronic renal disease, and their correlation with severity of CKD, and also to correlate variations in cutaneous changes with hemodialysis. 75 patients on CKD, including patients on hemodialysis, were examined for cutaneous changes. Creatinine clearance was calculated for staging of CKD. The common skin changes observed were xerosis (75%), hyperpigmentation (56%), pruritus (48%). Other changes seen were striae, purpurae, ecchymoses, Kyrle’s disease, pyodermas, mucosal, hair and nail changes and other infections. One case of Calcinosis cutis was seen. There was a significant decrease in pruritus(p=0.034) and an increase in pallor(p=0.001) in dialysis patients compared to others. There was also a remarkable increase in the diversity of skin changes that correspond with severity of CKD (p=0.044). Black pigmentation of the tongue, not usually seen was observed in 41% of patients. With an almost 100% prevalence in CKD, early recognition of these skin manifestations and prompt initiation of treatment can dramatically alter their course and even detect underlying renal disease.
To estimate the frequency of dermatoses in patients undergoing hemdialysis
Journal of Pakistan Association of Dermatology, 2019
Background The skin is an external reflection of many renal pathologies and hence serves as an important tool for the clinician. Mucocutaneous manifestations are commonly observed among patients with chronic kidney disease undergoing hemodialysis. Objective To estimate the frequency of dermatoses in patients undergoing hemdialysis. Study design Descriptive study. Place and duration of study Dialysis Centre, Shaikh Zayed Hospital, Lahore from 01.06.18 to 30.11.18. Materials and Methods One hundred and seventy seven patients of chronic kidney disease undergoing hemodialysis of both genders irrespective of dialysis duration were observed for various dermatoses. Results There were 109 (61.6%) males and 68 (38.4%) females and male to female ratio was 1.6:1. The age of patients ranged from 11-75 years with the mean age being 45.80±14.30 years. One hundred and twenty patients were found to have skin problems. Xerosis was most common (37.9%) followed by pruritus (30.5%) while diffuse hyper...
Cutaneous Manifestations in Chronic Renal Failure Patients
Medical Journal of Shree Birendra Hospital, 2011
Introduction: Chronic renal failure is a pathophysiologic process with multiple etiologies, resulting in the inexorable attrition of nephron number and function, and frequently leading to end stage renal disease. There are various cutaneous changes in chronic renal failure. Objectives: To observe the cutaneous manifestations in chronic renal falure and find out any difference in occurrence of cutaneous manifestation with modality of treatment of CRF. Methods: The study was conducted in 50 (fifty) adult patients with chronic renal failure and another 50 (fifty) patients with similar age admitted with other renal diseases but not suffering from chronic renal failure as control to facilitate comparison were considered in the Department of Dermatology and Venereology and the Department of Medicine, Shree Birendra Hospital, Chhauni from September 2008 to June 2010. Results: A significant occurrence of pruritus, xerosis and pallor in CRF patients: the highest being pruritus followed by ...
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