Renal failure is common in the United States with an estimated prevalence of 660,000 treated end-stage renal disease patients in 2015 [1]. Causes of renal failure are many, and complications from renal failure, underlying disease, and treatment are not infrequent. Examples of common skin manifestations include xerosis, pigmentary change, and nail dystrophies. Frequent disease-specific skin changes may be helpful in the diagnosis of primary disorders leading to renal disease or severity of disease including bullosis diabeticorum, sclerodactyly, or leukoctoclastic vasculitis. Some cutaneous changes, such as the multiple angiokeratomas of Fabry disease or the plexiform neurofibromas of neurofibromatosis, are pathognomonic of genetic disorders, which often lead to renal failure. Careful examination of the skin can provide crucial clues to diagnosis of renal failure causation and aid in monitoring complications.

Renal failure patients have an increased risk of infection, including skin and soft tissue infections. This increased susceptibility is multifactorial, due to the conditions causing the renal failure as well as complications of treatment and renal failure’s innate effects on patient health. These infections have a significant impact on patient morbidity, increased hospital and procedural demands, and the cost of health care. Many renal failure patients are seen regularly by their nephrology clinic caregivers due to the need for frequent dialysis and transplant monitoring. Familiarity with common skin and soft tissue infections by these caregivers allowing enhanced patient education, optimal infection prevention, and early recognition could significantly reduce the morbidity and cost of these disorders, such as diabetic foot syndrome, necrotizing fasciitis, and herpetic infections.