A comparative study of cutaneous manifestations in chronic kidney disease patients with those under dialysis and post-renal transplant patients

Abstract

Background: Dermatologic abnormalities are very common in Chronic kidney disease (CKD) patients and significantly impacts quality of life. They range from nearly universal xerosis and pruritus to uncommon conditions like acquired perforating dermatoses and nephrogenic systemic fibrosis. Cutaneous manifestations may vary among CKD patients with those on dialysis or received renaltransplantation. Early recognition of these conditions can significantly reduce the morbidity and mortality of these patients. Objective: To study the skin manifestations in CKD patients and how it differs from those undergoing dialysis or post-renal transplant patients. To find out how skin features vary with the duration of CKD and duration of dialysis. Methods: Institution based descriptive study was conducted in 45 patients with ESRD (patients with irreversible decline in kidney function) of diverse etiology who attended the nephrology or dermatology department. A detailed clinical history was taken and history of any comorbid condition were recorded. A detailed physical and dermatological examination was done in all cases. Dermatological manifestations observed were documented. Results: Total 45 patients (24 male and 21 females) included in this study. All patients present with at least 1 form of skin alteration. The manifestations are different in CKD pts. compared to those on dialysis or post-transplant group & hence need a different approach towards management. Due to prolonged use of immunosuppressant in kidney transplant recipients, opportunistic infections are very common. Conclusion:World is facing an escalate in the incidence of chronic kidney disease (CKD). Dermatologic abnormalities are very common in CKD patients and significantly impacts quality of life. They range from nearly universal xerosis and pruritus to uncommon conditions like acquired perforating dermatoses and nephrogenic systemic fibrosis. Cutaneous manifestations may vary among CKD patients with those on dialysis or received renal-transplantation. Duration of dialysis or time since transplant also affect the cutaneous abnormalities in CKD patients. Early recognition of these conditions can significantly reduce the morbidity and mortality of these patients.