Plasma immunoreactive beta-melanocyte-stimulating hormone and skin pigmentation in chronic renal failure.

Smith, Andrew G.; Shuster, Sam; Comaish, J.S.; Plummer, N. A.; Thody, A. J.; Álvarez-Ude, F; Kerr, D. N. S.

doi:10.1136/bmj.1.5959.658

Cited by 50 publications

(21 citation statements)

References 4 publications

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“…6,14,15 Pigmentary changes occurred due to increased levels of β-melanocyte stimulating hormone and due to inadequate excretion through kidney and dialysis. 16 Prevalence of hair changes present in the current study was 40% which was higher compared with other studies. 6,14 45% of the patients presented with dermatophytosis which was in accordance with a study done by Deskhmukh et al 15 The prevalence of oral mucosa changes was higher (30%) was compared with other studies.…”

Section: Discussioncontrasting

confidence: 71%

A study on dermatological manifestations among chronic kidney disease patients undergoing hemodialysis in a tertiary care centre

Mookambika

Murugan

2017

Int J Res Med Sci

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Background: Chronic kidney disease (CKD) is a progressive loss of kidney function over a period of months or years through five stages. The prevalence of end-stage renal disease (ESRD) in India is increasing with an estimated annual incidence of about 100 per million populations. About 50-100% of patients with ESRD have at least one associated cutaneous change. These cutaneous disorders can precede or follow the initiation of hemodialysis treatment, and there are more chances to develop newer skin changes during the course of hemodialysis therapy, which may affect the quality of life. Objectives of the study was to find out the prevalence of various dermatological manifestations in patients undergoing hemodialysis in a tertiary care centre. Methods: A cross sectional study was carried out in the general medicine department of a tertiary care Centre. All cases of chronic kidney disease were diagnosed according to the criteria of KDQQI CKD guidelines, age group between 30-60 years are included. Pediatric patients with chronic kidney disease, patients who had renal transplantations, patients on peritoneal dialysis and renal injury patients are excluded. Results: Out of the 100 study participants majority are males (60%). Majority of the patients belongs to lower socioeconomic status family (59%). Atleast one dermatological manifestation was present in all patients. 23% of the patients presented with two dermatological manifestations and 22% of the participants had three or more dermatological manifestations. Xerosis was the most common dermatological manifestation present among the patients. Conclusions: This study reflects that quality of life in dialysis patients is mainly depend on timely recognition and prompt management of these dermatological conditions.

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Section: Discussioncontrasting

confidence: 71%

A study on dermatological manifestations among chronic kidney disease patients undergoing hemodialysis in a tertiary care centre

Mookambika

Murugan

2017

Int J Res Med Sci

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“…Patients with ESRF, especially those maintained on HD, suffer from several cutaneous manifestations [5,8,11,12,16]. Persistent pruri tus is a symptom which the patient can usually hardly tolerate, and is so intense that the use of antipruritics often fails to afford sufficient relief [6,7,13,16], Some authors pointed out that the mast cell prolifera tion in various organs might induce pruritus [8], diarrhea and constipation, and bone marrow damage from a re lease of histamine [1,2,10].…”

Section: Discussionmentioning

confidence: 99%

Microangiopathic Changes of Subepidermal Capillaries in End-Stage Renal Failure

Ichimaru¹,

Horie

1987

Nephron

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Skin biopsies were taken from 63 patients with end-stage renal failure (ESRF) and 5 normal volunteers, 53 of whom were on maintenance hemodialysis (HD) and the other 10 without HD. They were examined with light and electron microscopy and subepidermal capillaries were subjected to image analysis. Thickening of the basement membrane (BM) with multilamination of the basal lamina, endothelial activation and chronic inflammatory cell infiltration with participation of mast cells were evident. The extent of these BM changes was correlated with the duration of HD, but not significantly correlated with the clinical findings indicative of arteriosclerosis. There was significant correlation between the duration of HD and mast cell proliferation or eosinophilia. We suspect that the subepidermal capillary changes represent an inflammatory reaction provoked by uremic toxins or by the repeated use of an artificial organ.

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“…Overall assessment of hypothalamic-pituitary sta¬ tus in uraemia is poorly documented although isolated abnormalities of individual anterior pitui¬ tary hormones have been reported e. g. TSH (Gon¬ zález-Barcena et al 1973;Ramirez et al 1976;Lim et al 1977), GH (0rskov & Christensen 1971;Czernichow et al 1976), Prl (Cowden et al 1978) and ß MSH-like immunoreactivity (Gilkes et al 1975;Smith et al 1975) whilst ACTH levels are normal. In general, it has been assumed that im¬ paired renal metabolism is the predominant under¬ lying abnormality to account for elevated hormone levels.…”

mentioning

confidence: 96%

Hypothalamic-pituitary function in uraemia

Cowden¹,

Ratcliffe

et al. 1981

Acta Endocrinologica

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In a study of 221 patients with progressive uraemia and after successful renal transplantation, all patients had normal levels of plasma 11-hydroxycorticosteroids and sex hormone binding globulin (SHBG). Concentrations of T4 and Ts fell significantly (P < 0.005) with progressive uraemia whilst TSH remained normal. Levels of gonadal steroids also fell significantly (P < 0.0005) and in some patients there was gonadal failure with LH and FSH > 50 U/l; in the remainder, there was a modest increase in LH and minor increase in FSH as renal function deteriorated. Elevated Prl concentrations (P < 0.005) occurred even in moderate chronic renal failure and levels rose with progressive uraemia. In patients on maintenance haemodialysis, TSH response to thyrotrophin releasing hormone (TRH) was signifi¬ cantly blunted (P < 0.01) at 20 min but showed a late rise at 60 min; basal levels of GH were elevated in 27% and there was a heterogeneous GH response to TRH; LH response to gonadotrophin releasing hormone (GnRH) was normal whilst response of FSH was significantly blunted (P < 0.01). Irrespective of basal Prl level, there was a grossly blunted Prl response to TRH and metoclopramide (MCP) and no suppression of Prl after acute administration of i.-dopa or bromocriptine. Following successful renal transplantation, endocrine status was entirely normal.It is concluded that gross biochemical endocrine abnor¬ malities arise with progressive uraemia, which are not ameliorated by maintenance haemodialysis but are abolished by successful transplantation. There is evi¬ dence of both hypothalamic and pituitary dysfunction contributing to these anomalies, which may be sensitive indices of non urea and creatinine related uraemic toxicity, and whose significance requires further evaluation.

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Plasma immunoreactive beta-melanocyte-stimulating hormone and skin pigmentation in chronic renal failure.

Abstract: Plasma immunoreactive (3-melanocyte 3timulating hormone (p-MSH) concentrations were greatly increased in patients with chronic renal failure. There was no correlation between the severity of the renal failure or the degree of pigmentation and the plasma p-MSH levels.

Cited by 50 publications

References 4 publications

A study on dermatological manifestations among chronic kidney disease patients undergoing hemodialysis in a tertiary care centre

A study on dermatological manifestations among chronic kidney disease patients undergoing hemodialysis in a tertiary care centre

Microangiopathic Changes of Subepidermal Capillaries in End-Stage Renal Failure

Hypothalamic-pituitary function in uraemia

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