Comparison of nail changes in chronic kidney disease under haemodialysis with patients on oral maintenance therapy
Keywords:
Chronic kidney disease, Haemodialysis, Maintenance therapyAbstract
Objective To compare the frequency of nail changes in Chronic Kidney Disease patients undergoing haemodialysis with patients on maintenance therapy. Methods This analytical cross-sectional study was carried out at Dermatology and Nephrology Department, Sahiwal Teaching Hospitals, Sahiwal, after approval from Institutional Ethical Review Committee. A total of 158 patients with chronic kidney disease of either sex and age were divided into two groups: Group A (patients under regular haemodialysis) Group B (patients on oral therapy). Patient’s demographic, clinical and laboratory data were recorded in predesigned proforma. Data were analyzed by using SPSS version 28. Results Out of total 158 patients, male female ratio was 1.1:1 and majority of patients (63.3%) were above age of 40 years. Most commonly reported nail changes in both groups were absence of lunula (65%, 57%), longitudinal ridging (54%, 58%) and onycholysis (45%, 35%) but variations were observed in their frequencies. There was no statistically significant difference in nail changes of both groups. Conclusion Patients with CKD undergoing HD therapy have slight higher frequency of nail changes compared to patients on maintenance therapy. Further studies with large sample size may elaborate results.References
Floege J, Bello A, Kawar B, Kossi ME, Nahas ME. Comprehensive clinical nephrology, 4th edition. United States of America: Elsevier saunders; 2010:907- 10.
Kabra R, Acharya S, Shukla S, Kumar S.Nail Changes in the Chronic Kidney Failure– A Cross Sectional Study. J Datta Meghe Inst Med Sci Uni. 2022;17:2-6.
Goel V, Sil A, Das A. Cutaneous Manifestations of Chronic Kidney Disease, Dialysis and Post-Renal Transplant: A Review. Indian J Dermatol. 2021;66(1):3-11.
Malkud S, Dyavannanavar V, Varala S. Cutaneous manifestations in patients with chronic kidney disease on hemodialysis. J Pak Assoc of Dermatol. 2020;30(3):490-6.
Aqil N, Nassiri A, Gallouj S, Mernissi FZ. Nail Disorders in Patients with Chronic Renal Failure. J Dermatol Res Ther. 2019; 5:065.
doi.org/10.23937/2469-5750/1510065
Saray Y, Sec¸kin D, Lin Gu Lec AT¸ Akgu Sn, Haberal M. Nail disorders in hemodialysis patients and renal transplant recipients: A case-control. J Am Acad Dermatol. 2004:30(2):197-203.
Martinez MAR, Gregório CL, Santos VP, Bérgamo RR, Machado Filho CDS. Nail disorders in patients with chronic renal failure undergoing hemodialysis. An Bras Dermatol. 2010;85(3):318-2.
Pushpa M, Murthy SC, Anvar MI. Mucocutaneous manifestations and nail changes in patients with end stage renal disease: A cross-sectional study. J Pak Assoc of Dermatol. 2021;31(2):191-200.
Thomas EA, Pawar B, Thomas A. A prospective study of cutaneous abnormalities in patients with chronic kidney disease. Indian J Nephrol. 2012;22(2):116-20.
Kohagura, K. The public health impact of hypertension and diabetes: a powerful tag team for the development of chronic kidney disease. Hypertens Res. 2023;46:339–40.
Wang M, Li J, Li Y, Yao S, Zhao M, Wang C, et al. The effects of hypertension and diabetes on new-onset chronic kidney disease: A prospective cohort study. J Clin Hypertens. 2020;22: 39– 46.
Elahi I, Nasir Z, Ahmed S, Raheel S. Chronic kidney disease; prevalence of nail changes. Professional Med J. 2018; 25(3):392-5.
Dyachenko P, Monselise A, Shustak A, Ziv M, Rozenman D. Nail disorders in patients with chronic renal failure and undergoing haemodialysis treatment: a case-control study. J Eur Acad Dermatol Venereol. 2007;21(3):340-4.
De Berker D AR, Richert B, Baran R. Acquired Disorders of the Nails and Nail Unit. Griffiths C .E.M, Barker J , Bleiker T, Chalmers R , Creamer D. Rook’s Textbook of Dermatology. 9th Edition. UK. Wiley Blackwell: 2016; Pages.95.12
Sheikh M, Malik LM, Jahangir M. Cutaneous manifestations of chronic renal failure. J Pak Assoc Dermatol. 2014;24 (2):150-5.
Harber R, Khoury R, Tomb R, Kechichian E. Splinter hemorrhages of the nails: A systematic review of clinical features and associated conditions. Int J Dermatol. 2016;55(12):1304-10.
Adejumo OA, Madubuko RC, Olokor AB, Aina OT. Skin changes and dermatological life quality index in chronic kidney disease patients in a tertiary hospital in Southern Nigeria. Niger J Clin Pract. 2019;22:245-50.
Gradinaru TC, Mihai M, Beiu C, Tebeica T, Giurcaneanu C. Melanonychia - Clues for a Correct Diagnosis. Cureus. 2020; 12(1):e6621.
Adégbidi H, Akpadjan F, Houngbo O, Vigan J, Dégboé B, Agbessi N, et al. Epidemiological and clinical profile of dermatoses observed in chronic hemodialysis patients at the National Teaching Hospital (NTH-HKM) of Cotonou, Benin. Dermatol Res Pract. 2020; 2020:9186309.
