Mucocutaneous manifestations and nail changes in patients with end stage renal disease: A cross-sectional study

Abstract

Background Mucocutaneous manifestations and nail changes are commonly seen in renal failure, more so in end stage renal disease (ESRD). Duration and treatment for renal disease may influence the frequency and type of these manifestations. Our objectives were to find the prevalence and pattern of mucocutaneous manifestations, nail changes in patients with ESRD, and their relation to duration of disease and mode of treatment i.e. on hemodialysis or without hemodialysis.   Methods A total of 170 consecutive patients with ESRD on hemodialysis or without hemodialysis, were examined for mucocutaneous manifestations and nail findings. Relevant investigations were done. Data collected was tabulated using simple statistical methods and chi-square test, wherever applicable.   Results Among 170 patients, 130 were male and 40 were female patients (M:F 3.25:1). Pruritus was present in 59 (34.7%) patients and frequency was more in those not on hemodialysis. Further, pruritus was seen more frequently in patients with longer duration of renal disease and hemodialysis. All the patients had at least one dermatological manifestation. Xerosis /acquired icthyosis was the most common skin finding, observed in  132 (77.6%) patients, more frequently  in patients with longer duration of disease and hemodialysis followed by diffuse pigmentation  in 51(30%) patients . Acquired perforating dermatoses were seen in 4 (2.7%) patients and cutaneous infections in 30 (27.5%) patients. Oral pallor was seen in 149 (87.6%) patients. Absent lunula was the most common nail finding observed in 105 (61.7%), followed by half and half nails in 62 (36.6%) patients.   Conclusion Mucocutaneous manifestations and nail changes are commonly encountered in ESRD. Frequency and spectrum of these changes may be related to duration of disease and treatment modality used.