Dermatological manifestations in children with chronic kidney disease: a study from a North Indian tertiary care institute

Abstract

Summary Background Dermatological manifestations due to impaired renal function in children with chronic kidney disease (CKD) are diverse and are an important cause of morbidity. Aim To determine the prevalence of dermatological manifestations in predialysis children with different stages of CKD and its association with various metabolic parameters. Methods This cross‐sectional observational study was conducted in 200 predialysis children with CKD stages 1–5 and 200 age‐ and sex‐matched healthy controls (HCs). Detailed dermatological examination was performed to check for any pathological/physiological changes in the skin, mucosa, hair and nails, and changes were recorded in a predesigned proforma. Results The median age of cases and HCs was 60.50 months (76.5% males) and 62 months (78.5% males) respectively. Skin manifestations were seen in 189 (94.5%) cases and 156 (78%) HCs (P < 0.001). The most common skin manifestation among cases was pallor (75.5%, P < 0.001) followed by xerosis (48.5%, P < 0.001), atopic diathesis (41.5%) and pruritus (13%, P < 0.001), while among HCs, the most common skin manifestation was atopic diathesis (46%), followed by pallor (24%) and xerosis (14%). Xerosis was found to be significantly associated with higher serum creatinine levels (P = 0.04) and hypocalcaemia (P = 0.03). There was no significant association found between pruritus and serum creatinine. Conclusion Xerosis was significantly associated with higher levels of creatinine and hypocalcaemia. Timely recognition of these symptoms and proper management can improve the quality of life in children with CKD.

Evaluation of Serum Complement Proteins and Biochemical Parameters in Patients with Chronic Kidney Disease-associated Pruritus

“…A recent study conducted in north India by Pratyusha et al, [40] reported that high creatinine levels were significantly associated with skin xerosis in hemodialysis patients. Persistent xerosis compromises the skin barrier and induces uremic toxin accumulation in the skin.…”