Cutaneous manifestations of chronic renal failure
Keywords:
Chronic renal failure, cutaneous manifestations, xerosis, pruritus, half-and-half nails, xerostomiaAbstract
Objective To determine the frequency of cutaneous lesions in patients of chronic renal failure (CRF). Methods 350 patients of CRF regardless of gender and cause, fulfilling inclusion criteria were enrolled from all the four medical units, nephrology unit and renal dialysis unit of Jinnah Hospital, Lahore. An informed consent was taken. Detailed examination and required investigations for cutaneous manifestations were carried out, noted and entered in a structured proforma. Results Out of 350 patients evaluated, 100% had skin changes. 186 (53%) patients were males and 164 (47%) were females. The most prevalent finding was xerosis present in 309 (88.3%) patients followed by pruritus in 271 (77.4%) patients. Among nail changes, half-and-half nails were present in 267 (76.3%) and among mucosal changes, xerostomia was present in 290 (82.9%) patients.    Conclusion Chronic renal failure is associated with complex array of cutaneous manifestations caused either by disease or treatment. The commonest are xerosis, pruritus, half-and-half nails and xerostomia.ÂReferences
Arora P, Verrelli M. Chronic renal failure. 2010.. Available from: URL: http://emedicine.medscape.com/article/238798-print. Accessed on 2012 May 1.
Rizvi AH, Manzoor K. Causes of chronic renal failure in Pakistan. Saudi J Kidney Dis Transpl. 2002;13:376-9.
Barosum RS. Pathogenesis of diabetic nephropathy Part 1. Kidney Forum. 2002;2:11-22.
Sakhiya V, Sud K. Burden of disease and management issues (end stage renal disease in India and Pakistan). Kidney Int. 2003;63:S115-S118.
Lynde C, Kraft J. Skin manifestations of kidney disease. Parkhurst Exchange. 2007;15(2). Available from: http://www.parkhurstexchange.com/clinical-reviews/ct_02_vol15.
Zucker I, David M, Yosipovitch G et al. Prevalence and characterization of uremic pruritus in patients undergoing haemodialysis. J Am Acad Dermatol. 2003;49:842-6.
Amatya B, Agrwal S, Dhali T et al. Pattern of skin and nail changes in chronic renal failure in Nepal: Hospital based study. J Dermatol. 2008;35:140-4.
Udayakumar P, Balasubramanian S, Ramanlingam KS et al. Cutaneous manifestations in patients with chronic renal failure on haemodialysis. Indian J Dermatol Venereol Leprol. 2006;72:119-25.
Nunley JR. Dermatologic manifestations of renal disease. eMedicine. Available from: http://emedicine.medscape.com/article/1094846-overview. Updated: Jan 23, 2014.
Szepietowski JC, Reich A, Schwartz RA. Uraemic xerosis Nephrol Dial Transplant. 2004;19:2709-12.
Manenti et al. Uraemic pruritus: clinical characteristics, pathophysiology and treatment. Drugs. 2009;69:251-3.
Dayachenko P, Shustak A, Rozenmon D. Haemodialysis related pruritus and associated cutaneous manifestations. Inter J Dermatol. 2005;45:664-7.
Dar NR, Akhtar A. Clinical characteristics of uraemic pruritus in patients undergoing haemodialysis. J Coll Physicians Surg Pak. 2006;16:94-6.
Avermaete A, Altmeyer P, Bacharach M. Skin changes and tumors after renal transplantation. Nephron. 2002;91:188-96.
Hajheydari Z, Makhlough A. Cutaneous and mucosal manifestations in patients on maintenance haemodialysis. Iran J Kid Dis. 2008;2:86-90.
Sultan MM, Mansour HH. Cutaneous manifestations in Egyptian patients with chronic renal failure on regular haemodialysis. J Egypt Women Dermatol. 2010;7:49-57.
