Cutaneous Abnormalities in Uremic Patients

Abstract

94 uremic patients, 68 on regular hemodialysis treatment (RHT) and 26 on chronic ambulatory peritoneal dialysis (CAPD), were followed for up to 20 months in search of dermatological manifestations. 79% of RHT and 76% of CAPD patients had some kind of cutaneous lesion. The most characteristic features of cutaneous involvement in RHT and CAPD patients were: cutaneous xerosis, pruritus, infectious manifestations and disorders of pigmentation. In 4 RHT patients, precancerous and cancerous manifestations were also observed.

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

“…Pico et al 10 and Bencini et al 14 found prevalence of kidney disease in 100% and 79% patients respectively. Udayakumar et al 19 has performed a study among patients receiving haemodialysis and cutaneous disorders were found in 82% patients.…”

“…The etiology of pruritus in CKD is unknown. However, it has been associated to renal insufficiency, secondary hyperparathyroidism, xerosis, increased serum levels of magnesium, calcium, phosphate, aluminum, histamine, proliferation of nonspecific enolase-positive sensory nerves in the skin, hypervitaminoses A and iron deficiency anemia [14][15][16] . Pallor of the skin due to anemia reported as the hallmark of CKD.…”

Complex Wounds in Patients Receiving Hemodialysis

“…Not only abdominal surgical wounds, but also all surgical sites sometimes develop poor wound adhesion causing a complex ulcer ( Figure 5). Mistrík et al reported at significant decrease in skin blood flow during the HD procedure and concluded that the skin blood flow may be impaired in HD patients, which leads to the development of difficulty in healing skin wounds 3) . Consequently, patients with end-stage renal disease were associated with higher resource use, complication rates, and mortality when they were injured 22) .…”

“…Patients receiving hemodialysis (HD) often have complex chronic wounds, which are hard to heal because of complications of other diseases, including DM, calciphylaxis, collagen disease, arteriosclerosis obliterans, chronic anemia, and weakness of the skin (Figures 1-3) [1][2][3] . Subsequent infection of necrotic skin tissue is associated with the risk of sepsis, which may be fatal if the blood access shunts become infected 4) .…”

Chronic Renal Failure - Pitfalls in Diagnosis

“…Pitting, burrowing, leuconychia, half and half sign [12,13] showing lower area of nail as white and upper half as pink or brown are markers of CRF. In advanced renal failure, "tongue sign" i.e., a swollen tongue with teeth markings on the sides is a frequent observation [14].…”