Dermatological manifestations in patients with chronic kidney disease on regular hemodialysis

Abstract

Objective To determine the frequency of different dermatological manifestations in patients of chronic kidney disease on regular hemodialysis. Methods In this descriptive cross-sectional study, 160 patients were included from October, 2014 to April, 2015. Dermatological examination was performed and investigations were carried out where required to diagnose. Data was stratified for age, gender and duration of disease. Poststratification chi square test was applied. P value ≤ 0.05 was considered significant. Results Mean age of the patients was 43.93±12.12 years. Out of 160 cases, 90 (56.2%) patients were males while remaining 70 (43.8%) patients were females. Mean duration of chronic kidney disease was 2.54 years with minimum 3 months and maximum 14 years. Patients were on hemodialysis, duration ranging from 3 months to 9 years. Distribution of dermatological lesions were as follows: pallor was present in 119 (74.4%) patients, hyperpigmentation in 115 (71.9%) patients, xerosis in 96 (60%), pruritus in 91 (56.9%), ecchymosis and petechiae in 28 (17.5%), fissured tongue in 18 (11.3%), angular cheilitis in 3 (1.9%), ulcerative stomatitis in 22 (13.8%), half-and-half nails in 55 (34.4%) and koilonychia was present in 5 (3.1%) patients. Other manifestations seen were reactive perforating collagenosis in 4 (2.5%) and onychomycosis in 6 (3.7%) patients. Out of 91 (56.87%) pruritic patients, mild pruritus was observed in 27 (16.9%) patients, moderate in 36 (22.5%), intractable and severe pruritus in 14 (8.8%) patients. Out of total 96 xerotic patients, xerosis was mild in 35 (21.8%) patients, moderate in 38 (23.8%), severe in 23 (14.4%) patients. Conclusion Pallor, hyperpigmentation and xerosis were most common in CKD patients on hemodialysis, so early recognition of cutaneous signs can relieve suffering and decrease morbidity.