Cutaneous Manifestations of Chronic Kidney Disease-An Observational Study in 100 Cases

Abstract

Chronic Kidney Disease (CKD) presents with an array of cutaneous manifestations. Newer changes are being described since the advent of haemodialysis, which prolongs the life expectancy, giving time for these changes to manifest. This cross sectional study was performed in 100 cases of CKD admitted in nephrology department of Dhaka Medical College Hospital (DMCH) and Bangabandhu Sheikh Mujib Medical University (BSMMU) from April 2008 to August 2008 to evaluate the prevalence of dermatologic problems. Among them most belong to 2nd to 5th decade, 68 are male and rests are female. Glomerulonephritis (44%), Diabetes mellitus (22%), Obstructive uropathy (13%) and Hypertensive nephropathy (12%) are found common causes of CKD. Among these patients 38% patients were treated with conservative treatment, 31% with intermittent peritoneal dialysis (IPD), 19% with haemodialysis and 12% with some form of immunosuppressive therapy. Total 88% of study population had some form of skin disorder; pallor was the most common (82%), while xerosis (61%), pruritus (53%), pigmentation (37%) and bacterial infection (37%) were other common problems. Purpura and fungal infection was 29% and 27% respectively. Viral infection (9%), dermatitis (4%), gynaecomastia (1%), kyrle's disease (3%) are relatively less common findings. Lindsay's nail was seen in 23% of patients and was more prevalent in glomerulonephritis and diabetic patients with prevalence of 13% and 9% respectively. Other nail changes included koilonychia (4%), subungual hyperkeratosis (1%), splinter hemorrhages (3%) onychomycosis (8%) and Beau's lines (1%). So, CKD is associated with a complex array of cutaneous manifestations caused either by the disease or by treatment.

Cutaneous abnormalities in patients with end stage renal failure on chronic hemodialysis. A study of 458 patients.

“…The incidence of cutaneous manifestations was ranging from 50 to 100% in different studies. [1][2][3][4][5][6][7][8][9][10][11] Uremic pruritus is the most common symptom in our series. Its prevalence varies from 15% to 90%.…”

Cutaneous Manifestations in Patients with Chronic Kidney Disease on Hemodialysis at Prince Hashem Bin Al-Hussein Hospital in Al-Zarqa

“…Pallor was reported as the hallmark of chronic renal failure. (19) It was observed in 80% of our patients. Udayakumar et al detected pallor in 60% of their patients.…”

Cutaneous Abnormalities in Chronic Kidney Disease Patients with and without Dialysis

“…Xerosis was the most common cutaneous abnormality (79%) in the study done by Udayakumar et al among patients on dialysis [7]. Thomas et al [17] and Leena et al [21] also observed xerosis 66.7%…”

“…Thomas et al [17] and by Leena et al [21] respectively. Diffuse hyperpigmentation on sun-exposed areas were seen in 33.3% among total CKD patients in this study, which was consistent with these previous studies.…”